Medi-Health Department

Job Specification

Education Level: Candidate should possess minimum MBBS Degree/ Bachelor degree in Pharmacy/Pathology/Nursing (with valid license from their respected Council)

Experience Required: Prior experience in hospital Pharmacy and related fields are encouraged to apply.

Job Description

• Candidate should have a strong communication skill and shall handle inquiries related to Pharmacy especially during claim inspection.
• Developing and filing new products of Health Insurance.
• To incorporate empanelment with different hospitals in Kathmandu valley and also to tie up with them for business Support.
• To, get quotations from different empanelled hospitals with lowest rate and provide discounted rate of cashless health insurance benefit to the prospective customers than that of Competitors in the market.
• To act as a mediator and Claim Assessment team between empanelled hospital and Siddhartha Premier Insurance ltd.
• Training of Empanelled hospitals Personnel regarding Cashless Health Insurance benefits provided under the policy issued.
• Ensure that cashless benefit offered to the customers is restricted to coverage offered under the policy and no excess benefit is paid by the hospitals with which MOU is entered.
• Identifying & generating details of prospective areas for Health Insurance and plan and strategies opted to generate business there from.
• Cashless benefit payment cycle should be made effective and claims should be timely paid off.
• Creation of Underwriting Guidelines.
• Monthly reviewing of the Claim Procedure made and reporting the same to the higher Authority without fail.