Medical Authorization OP

Posted 2 months ago

Job Description:

  • 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

Qualification:

  1. Graduate – Medical Qualification (MBBS Doctor),BSc Nursing, BDS, BPharm
  2. Excellent command over English (both verbal and written)
  3. Strong Customer Service Skills

Prior experience in Insurance industry preferably TPA

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