Sector: Medical / Healthcare
Experience: 1 to 5 years
Health Insurance Doctor job available in Karachi for an Insurance company. An ideal candidate should have done MBBS (from Pakistan) with valid PMDC registration along with 1 to 5 years of experience after house job in reputable hospitals, experience in health insurance would be preferable but not mandatory.
Health Insurance Doctor job responsibility includes reviewing patient records using medical coding procedures.
- Communication with Insured Members: To attend insured member’s queries in respect to their policy coverage, benefits, limits & exclusions; and assist them in obtaining required medical services from network and non-network hospitals.
- Communication with Clients: To meet clients on regular/when required basis to know their problems and find most appropriate solutions of the problems in accordance with agreement with them and company policy
- Communication with Hospitals: To ensure direct assistance to the medical providers with respect to policy terms and conditions, exclusions and limit of coverage and attend their inquiries to clarify on any raised problem.
- Required to visit medical providers to follow upon patients & check if medical providers are providing standard services without incurring delays to our insured members and to discuss and negotiate with the treating physician problems that may arise from time to time in respect to applied medical procedures
- Review, analyze & discuss with medical providers so as to the length of stay, mode of treatment, to ensure proper & necessary treatments are given within a reasonable cost.
- To monitor locally admitted in-patient cases.
- Assist in the claims management, medical underwriting, other activities assigned from time to time company management.
- To be available 24/7 on helpline for providers/clients/insured members
- Goal oriented
- Committed Team Player
- Good Communication skills
- Analytical skills
- Excellent skills in MS Word, MS Excel & PowerPoint
Apply now at firstname.lastname@example.org
Kindly mention the job title Health Insurance Doctor in the email
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