Tarun
Location
Madurai | India
Job description
Role: Hospital Administrator
Type: Full Time Job Description Roles and Responsibilities - Ensure an effective and efficient Claims facilitation process and accountable for appropriate job allocation and coordination amongst the team. - Monitor the productivity of the Data Management Services team by ensuring that Claims (cashless /reimbursement) received at Branch/Zone are uploaded on daily basis along with the important documents. - Monitor escalations from customers/clients being reported by interacting with respective Zonal/Corporate Medical team and ensure grievance process is precisely implemented by the nominated grievance officers. - Supervising and monitoring all legal issues relating to claims including Ombudsman /Consumer forum. - Effectively communicate claim control measures to the Operating Offices and ensure that they are implemented. - Keep track on sudden inflow of claims from any particular non-tertiary care hospitals and try to get confidential report about such hospitals and keep the Vigilance team informed. - Hold regular meeting of TPA desk officers of Network hospitals. - Monitor total cash-flows to hospitals and ensure that we get maximum early payment discount / avoid no penal interest paid for delayed payments. - Keep track on working of FVR activities and ensure that same FVR doctor is not sent regularly to any one hospital. - Attend meeting with various Marketing teams to understand market trends/customer grievances/ and ensure they are addressed. - Coordinate with CMU for any underwriting related issues escalated to Zonal Office. - Periodic meeting with Regional Vigilance Officers and guide them on carrying out effective investigation. - Any other responsibility as deemed fit by the Management.Job tags
Salary
