Verified Job
Healthcare
Doctors (experience) Jobs: Care Health Insurance
Healthcare
#751544
Remote / WFH
Care Health Insurance, Care Health Insurance · Kolkata, West Bengal ·
Job Description
Job description
Job Requirements
• Check over insurance claims forms as they are submitted and review each section for accuracy and completeness
• Confirm that the patient and the treatment or prescription are covered parts of the insurance plan by researching the plan details using a computerized database or calling the physician's office
• Submit each insurance claim after verification for final processing via an electronic submittal form system and review the reception of the claim with a final check
• Interpret the language in the overview of benefits summary explanation for the insurance policy and apply interpretation to the claims review process
• Update policy forms and claims information when insurance coverage changes have occurred and notify appropriate parties of the changes when necessary
• Maintain knowledge of all appropriate medical insurance coverage laws in the local, state, and federal jurisdiction area when reviewing claims submissions
• Follow all required medical privacy laws when discussing private information about patients with physicians, healthcare managers, or other staff members in the insurance agency
Work Experience
• Good in MS Excel
• Required experience in health insurance and TPA
• Knowledge of the TPA claim process
• BDS, BPT, MPT, BHMS, BUMS BAMS, can apply only
Job Requirements
• Check over insurance claims forms as they are submitted and review each section for accuracy and completeness
• Confirm that the patient and the treatment or prescription are covered parts of the insurance plan by researching the plan details using a computerized database or calling the physician's office
• Submit each insurance claim after verification for final processing via an electronic submittal form system and review the reception of the claim with a final check
• Interpret the language in the overview of benefits summary explanation for the insurance policy and apply interpretation to the claims review process
• Update policy forms and claims information when insurance coverage changes have occurred and notify appropriate parties of the changes when necessary
• Maintain knowledge of all appropriate medical insurance coverage laws in the local, state, and federal jurisdiction area when reviewing claims submissions
• Follow all required medical privacy laws when discussing private information about patients with physicians, healthcare managers, or other staff members in the insurance agency
Work Experience
• Good in MS Excel
• Required experience in health insurance and TPA
• Knowledge of the TPA claim process
• BDS, BPT, MPT, BHMS, BUMS BAMS, can apply only
