Vacancy Description
Key Responsibilities:
Review prescriptions to assess whether the diagnosed disease/condition is covered under the customer’s insurance policyPerform basic quality checks on prescriptions including:
○ Verifying doctor’s name, registration ID, and specialization.
○ Ensuring mandatory details are present (diagnosis, medicines prescribed, patient details, date, etc.)Identify and report inconsistencies or incomplete documentationWork closely with internal teams to seek clarifications or escalate exceptionsEnsure adherence to internal SOPs, claim processing timelines, and confidentiality normsMaintain records of reviewed prescriptions with appropriate tagging (approved/needs clarification/rejected)Monitor provider/client performance, analyse the data, and prepare report to keep clients and internal stakeholders informedProactively visit clients at their location to understa...
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