	JOB DESCRIPTION
BASIC INFORMATION
Position Title & Designation	Executive - Mediclaim	JD Code	SHB/XXX/DEPT/NNN
Job Family	Business Support	Department	Mediclaim
ROLE DETAILS To be filled up as per the requirement of the Division / unit / function / territory
Grade	B1	Reporting To	Mediclaim Manager
Division	Unit	Unit
LOCATION DETAILS Please mention the correct office location of the Role selected above and fill in the other geographic details
Base Location (City)		Country	India

Job-Holder Specifications
QUALIFICATION	Basic Qualification / Education / Vocational Training	Graduation in any discipline
QUALIFICATION	Advanced Qualification / Certification / Specialist Training	NA
EXPERIENCE	Minimum Experience	1-2 years
EXPERIENCE	Specific / Relevant Experience	1-2 years
COMPETENCIES	Functional Skills and Capabilities	Behavioural Courteous and professional approach Responsible in nature Polite in speech Problem solving ability Tolerant Functional Knowledge about mediclaim procedure for TPA Well equipped with computers Thorough with company knowledge and packages Documentation of data

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Objective

To carry out the administrative and billing procedure by providing accurate estimates, checking the outstanding and smooth discharge process for mediclaim clients in the Mediclaim department.

Key Responsibilities

Administrative

Attending and counseling patients for mediclaim
Explaining policies, explaining packages and mediclaim documentation
Coordinate for consultation, packages if needed
Thorough checking of patient documents
Forwarding and sending documents to TPA and follow up with the companies
Informing patients about the approval and payment breakage
Entering data on portals, excel and care works.
Admission of patients and coordinating for internal query resolution
Coordinating with OT, admission, billing, OPD and resolving their queries
Sending the discharge documents to the company, follow up with them, making checklist and entering the data on portal
Sending the patient data to billing department
Preparation of two document copies: one for patient and another for hospital records
Attending, answering and guiding patient queries on calls and mails
After discharge, resolving query and help in sorting queries
Refunding of patient amount in case of excess payment received
Informing, couriering and mailing patients about queries
Coordinating among units and TPA as per requirement (eg: Shifting)
Clearing of all queries before completion of duty hours
Attending queries after duty hours as per requirement
Coordinating within the department as per requirement

Employee Name	Yash More	Employee Signature
Received on (Date)
Version No: 001/ 2018-19