Fraud Investigator @ Talish Solutions

Job Description

: -
Handling customers on the ground within policy terms in sync with hospitals and driving savings by bill audits and negotiation with the hospitals
Handling 7-10 hospitals in the vicinity by as and when required visits
Knowledge of Hospital Billing systems and evaluating medical bills
Best clinical practices - Clinical knowledge for evaluation of medical files
Communication skills for negotiation with Hospital management
Market knowledge concerning disease and surgical procedure trends
Problem-Solving ability: Address insured/Patient concerns related to claims

Qualification: -
Graduate Medical background, MR (B pharma, with hospital billing understanding), BHMS or BAMS (with Insurance/insurance TPA or bill audit experience), MHA will be preferred.

Experience: -
2+ Years in health insurance/health insurance TPA or claims handling/audit
- Candidate must have excellent bill/medical negotiation skills & customer handling skills.
- Candidate must have excellent knowledge of health insurance / Health TPA domain.
- Possessing fluent communication skills in Hindi/English and the local language of the State/region.

Selection Criteria: -
- Local/outstation travel as per the job requirement
- Own a vehicle for travel
- Adequate functional computer literacy which shall include understanding of Microsoft Office Suite and navigating through Internet Portals.
- Candidate should be proactive & disciplined towards managing daily tasks.
- Candidate should be able to multi-task and handle complex situations and customers.

Intrested Candidate Kindly contact Kashvi Thakkar
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Employement Category:

Employement Type: Full time
Industry: Insurance
Role Category: DoctorAllied Health Services
Functional Area: Not Applicable
Role/Responsibilies: Fraud Investigator

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