Medical Officer- Claims & Operations- Hiring Freshers

Job description

Role : Medical Officer

Work from Office only

Job Descriptions:

• Check the medical admissibility of a claim by confirming the diagnosis and treatment details.
• Scrutinize the claims, as per the terms and conditions of the insurance policy
• Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc.
• Understand the process difference between PA and an RI claim and verify the necessary details accordingly.
• Verify the required documents for processing claims and raise an IR in case of an insufficiency.
• Coordinate with the LCM team in case of higher billing and with the provider team in case of non- availability of tariff.
• Approve or deny the claims as per the terms and conditions within the TAT. Role & responsibilitiesRequired Qualification : BAMS and BHMS doctors only Role & responsibilities

Preferred candidate profile

Looking for fresher Doctor

Education qualification-BAMS, BHMS