Job Description
**JOB PURPOSE**
**The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of benefits. He/She should provide accurate and relevant medical coverage details and maintain pre-approvals and claims processing as per the defined terms and policies of the organization.**
**RESPONSIBILITIES AND DUTIES**
+ Processes claims from members and providers.
+ Assists queries from providers and payers via phone calls or e-mails.
+ Maintains files for authorizations and other reports.
+ Assesses and processes claims in line with the policy coverage and medical necessity.
+ Be fully versed with medical insurance policies for various groups / beneficiaries.
+ May assist in training colleagues and asked to share knowledge.<...
**The job holder is responsible of serving providers and insurance companies by determining requirements, answering inquiries, resolving problems, fulfilling requests and maintaining database. He/She is responsible for processing as per terms of benefits. He/She should provide accurate and relevant medical coverage details and maintain pre-approvals and claims processing as per the defined terms and policies of the organization.**
**RESPONSIBILITIES AND DUTIES**
+ Processes claims from members and providers.
+ Assists queries from providers and payers via phone calls or e-mails.
+ Maintains files for authorizations and other reports.
+ Assesses and processes claims in line with the policy coverage and medical necessity.
+ Be fully versed with medical insurance policies for various groups / beneficiaries.
+ May assist in training colleagues and asked to share knowledge.<...
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