 Processing of Health Reimbursement Claims such as Corporate, Retail, Mass claims as per healthcareguidelines in Fast Track Health application. Ensuring and verifying the policy period, terms and conditions of the claim and tag to correct UHID and Policy No as they are important for processing. Analyzing the claim case by understanding the medical claim history, policy period and process the claim. Generating a Unique ID number for a claim which can be used at the time of… Show more  Processing of Health Reimbursement Claims such as Corporate, Retail, Mass claims as per healthcareguidelines in Fast Track Health application. Ensuring and verifying the policy period, terms and conditions of the claim and tag to correct UHID and Policy No as they are important for processing. Analyzing the claim case by understanding the medical claim history, policy period and process the claim. Generating a Unique ID number for a claim which can be used at the time of processing at other levels, which helps in smoothen the process. Review and check medical documents for processing the claim, if any deficiency in documents we will be updating remarks/summary explaining how the claim has made deductions through mails to customer. Coordinates with CRM team during claims discrepancies, and document deficiencies. Handling and processing the query claims within the TAT. Responsible for the accurate processing and completion of health claims within turnaround status. Ensuring timely communications of any issues and /or information needed to complete the claim process to be done. Handling the queries regarding policy, coverage, & claim matters. Also work with team for strengthening claim control and standardizing the claim practices. Ensuring that the TAT claims are processed and hand over to payment Request team. Involved in monitoring the new associates till they learn the process completely to achieve their targets. Handling the Electronic Fund Transfer in the EFT Module application. Approving the claim which contains PART-C and Cancelled Cheque in the claim form and rejecting the Claim by raising a query to the client if they are not provided. Checking the Account details of the policy holder such as Account no and IFSC code and sharing the data to the other team for the payment. Active Participant and Organizer of all the team activities on and off the floor e.g. Team lunches, team outings, charity, work, etc. Show less

 Policy generation in GENISYS configurator. All mails related policy generation and all types of endorsements. Preparing Dash Board to the Dealers and Insurance company as per there requirement  No claim bonus confirmation and updating in policy to PAN India dealers. Sending the 64vb reports and confirmation through mails. Maintaining quality reports for the process requirement. NCB verification through IIB portal checking the NCB % and publishing the reports to… Show more  Policy generation in GENISYS configurator. All mails related policy generation and all types of endorsements. Preparing Dash Board to the Dealers and Insurance company as per there requirement  No claim bonus confirmation and updating in policy to PAN India dealers. Sending the 64vb reports and confirmation through mails. Maintaining quality reports for the process requirement. NCB verification through IIB portal checking the NCB % and publishing the reports to insurance companies on daily basis. BRS uploads in GENISYS configurator.  Uploading bulk of data through Excel. Surveyor updating in system and where ever surveyor is not appointed we will appoint the surveyor with the help of insurance company. Sending the 64vb reports and confirmation through mails Show less