- Scruitiny of Claims coming form different Panel and Non Panel hospitals
- Assess the medical necessaity and compatibility with the policy of the investigations being done at hospitals.
-Approval and Issuance of Credit Letters to Jubilee Health’s panel Hospital and clients as per terms and conditions of the policy.
-Advice /Initiate Claims Investigations of claims purely on Personal Judgment.
-Coordination with the Hospital Management Section, Jubilee Health.
-Coordination with the Claims Section, Jubilee Health
-Coordinate with Customer Service Officer for assisting client / patient at the panel hospital.
-Coordinate with Case Manager for access to patient medical Information.
-Coordinate with Corporate Section of the Hospital
-Coordination with doctors of other shifts for continuity of patient care
-Attend Client Queries as per pre-defined Terms and Conditions of the policy-
Suggest ways and means to bring improvements in the present work process.
-Communicate with Attending doctors and clients in clarifying Jubilee Health policy terms and conditions