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What are the main tasks for claim manager?

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Question added by dana tutunji , Architect , Helou Trading Co
Date Posted: 2013/06/26
Tarek Barakat
by Tarek Barakat , Reconciliation Manager , Accumed Practice Management - RCM


1- supervising claim receiving within the agreed contracutal time duly with all required documents.
2- supervising claims technical & medical evaluation.
3- creating market benchmark using claims petterns & profiles.
4- providing fraud dectection/prevention unit with data & pinpoint fraud triggers.
5- promoting & developing claim adjuster performance & production.
6- directing claim processors to acheive the prospected production target.
7- due payment settlement & reconciliation.
8- coordination with other operaion unit (approval & network) to reap optimal results.

Susant Kumar Rout
by Susant Kumar Rout , Senior Medical Consultant , National Life & General Insurance Company SAOC (ONIC Holding Group)

Triggering networking team about the over charging of tariff accordance with the market price

 

SESHAGIRI LAKKANIKI
by SESHAGIRI LAKKANIKI , SENIOR CONSULTANT , A leading MNC Insurance Broking organization

Expeditious and judicious claims settlement with least administration cost and to contribute to the overall organization goal of earning reasonable operating surplus.

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