Customer Service Officer

• Processing of cashless / reimbursement claims request received from the hospital.
• Proper scrutiny of the medical documents received from the hospital/ patient and ask for relevant details to corroborate with the available diagnosis.
• Review the treatment details/ medication regimen given during hospitalization and ask for justification from treating doctor if treatment protocol is not appropriate to the diagnosis.
• Collate the medical details with the applicable policy terms to arrive at the final decision of claims adjudication.
• . Handling grievances effectively. Read more