Care Assessor evaluates medical claims, conducts patient visits, and manages health authorizations, requires a Nursing/Clinical Medicine/Health Degree/Diploma and 4+ years clinical experience.
Key Responsibilities
Reviewing
and issuing pre-authorization;
Handling
the 24hour call center (cell phones /office lines) and responding to clients
queries as they arise;
Interacting
with clients, brokers, clinicians, APA relationship officers and schemes HR’s
as required to resolve problems/update progress in a manner consistent with the
principles of the policy;
Conducting
hospital visits to assess patient’s care throughout continuum of care for
diagnosis/procedures as well as maintaining the client’s /provider
relationship;
Reporting
adverse occurrences relating to clients’ management, policy with
appropriate action to ensure compliance with quality patient care;
Coordinating
step down management and referrals for all clients with chronic diseases;
Participating
in health talks/wellness camps and service meetings;
Participating
in company CSR and brand building activities in liaison with other departments.
Academic
Qualifications
Bachelor’s
degree in relevant degree
Skills and Attributes
Leadership
skills
Interpersonal
and Communication skills
Analytical
skills
Professional Qualifications
Relevant
professional qualification
Experience
At least
4 years’ relevant experience
