Medical Officer

• 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 & responsibilities

Interested candidates can drop their CV's to [email removed] or whatsapp on [phone removed]