MEDICAL CLAIMS INVESTIGATION OFFICER
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1. Contact clinics and hospitals to verify policyholders' medical histories and establish the presence of pre-existing conditions. 2. Write to clinics and hospitals to request written evidence of policyholders' pre-existing conditions. 3. Process payments to clinics and hospitals for medical reports and completed questionnaires. 4. Follow up with clinics and hospitals to ensure timely receipt of requested medical reports and completed questionnaires. 5. Document all findings and present them to the Claims Head for adjudication. 6. Provide regular updates to Management on the status of ongoing claims investigations.
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