• Provides verbal pre-approval for medications, laboratory investigations, and out-patient procedures, maternity, dental and optical cases as per the Insurance Companies specific coverage.
• Collaborates with doctors and other medical practitioners within the medical team regarding medical conditions that require specific indication on every approval (Inpatient and Outpatient).
• Meet all key performance indicators set for call/claim handling (meet call/claim production call/claim quality, system adherence and attendance, complete call log, manage call reports).
• Guides Network Providers on clarification on Policy information
• Graduate Medical Qualification (MBBS Doctor),BSc Nursing, BDS, BPharm
• Excellent command over English (both verbal and written)
• Strong Customer Service Skills
Prior experience in Insurance industry preferably TPA