Deputy Manager

• End to end communication with consultants and other stake holders related to Scheme (e.g. MA Yojana) approvals and other processes.
• To work with team for Scheme Pre auth approvals, additional approvals, discharge, dialysis and OPD follow ups in in Software.
• Checking all IP files before dispatch and ensure to match with preauthorization and medical records, ensure to collect all documents as per Check list at the time of discharge for claim process.
• To keep vigilance on claims submission of Schemes as per TAT in coordination with Team.
• Resolving queries of Schemes post file submission and ensure to work on reduce the same by regular monitoring talking to Schemes team and Consultants.
• In case of visits required at MA Yojana office for any queries will be assisting Finance team.
• To confirm cluster details with doctors and process for additional approval.
• To ensure and hasten the procedure complete for HINAI admissions.
• Will be getting involved in disallowance meeting as & when required for medical queries
• Going to be a Single Contact person for any TPA / Corporate / Admission / Estimations Desk for any assistance required related to Medical Inquiries.
• Ensure to give appropriate codes/ Cluster details for all the schemes.
• Before discharge checking files for any lacuna in the clinical records.

Fortnight Report:

MA Yojana / TPA /Corporate Query Type of Clinical Errors in the discharge files, Repetitions Dept wise.

KPI:

MA File Query Submission TAT 2 days