**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. + Accurately assesses eligibility within the policy bound...