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Claims settlement operations within the scope of cooperative health insurance represent one of the fundamental pillars for risk management and customer acquisition in the insurance sector. This program serves as a practical step to develop participants' competencies by providing them with the specialized knowledge and applied skills necessary to manage the health insurance claims handling process. This includes receiving notifications, evaluating requests, and completing settlement operations, with a focus on the relevant financial aspects and regulatory frameworks. The program also covers methodologies for estimating financial reserves, including reserves for claims under processing and methods for calculating reserves for claims that have occurred but have not yet been reported.
Claims settlement operations within the scope of cooperative health insurance represent one of the fundamental pillars for risk management and customer acquisition in the insurance sector. This program serves as a practical step to develop participants' competencies by providing them with the specialized knowledge and applied skills necessary to manage the health insurance claims handling process. This includes receiving notifications, evaluating requests, and completing settlement operations, with a focus on the relevant financial aspects and regulatory frameworks. The program also covers methodologies for estimating financial reserves, including reserves for claims under processing and methods for calculating reserves for claims that have occurred but have not yet been reported.
Insurance
Credit
Not Exist
Lecture
Case Studies +2
Lecture
Case Studies
Brainstroming
Dialogue and Discussions
Other
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This provides you with the opportunity to select the available times that suit you best for participation in our program. These times represent slots during which we are ready to welcome you and provide assistance and guidance.
• Comprehend the pivotal role of the health insurance claims department in maintaining the financial sustainability of insurance companies.
• Analyze the operational stages of the claims processing cycle, starting from data collection and verification, through processing and alignment, to ensure compliance with quality standards.
• Apply procedural regulations and controls to detect irregular claims and system leakage cases.
• Develop strategies for engaging with relevant stakeholders using advanced negotiation techniques in claims-related matters.
• Design mechanisms for establishing financial reserves and calculating loss indicators to manage high-value claims.
