Urgent Requirement For Medical Officer

Medi Assist Healthcare Services Limited

Designation: Medical Officer/Senior Medical Officer

Function: Claims PA/RI Approver

Location: Bangalore

Educational Qualification : MBBS,BHMS, BAMS, BDS, B Sc Nursing

Industry Type Hospital/TPA/Healthcare/Insurance

Roles and Responsibilities:

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.

Handle escalations and responding to mails accordingly.

Key Results and Outcomes driven by this role:

Error-free processing (100% Accuracy)

Maintaining TAT

Productivity (Achieve the daily targets)

Technical Competencies:

Analytical Skills

Basic Computer knowledge

Type writing skills

Behavioral competencies:

Communication skills

Decision Making

• Experience

  1 - 4 Years

• No. of Openings

  30

• Education

  BDS, BAMS, MBBS

• Role

  Medical Officer

• Industry Type

  Hospitals / Medical / Healthcare Equipments

• Gender

  [ Male / Female ]

• Job Country

  India

• Type of Job

  Full Time

• Work Location Type

  Work from Office

• Face interview location

  IBC Knowledge Park MediAssist 4th Floor ,Near Dairy Circle Bannerghatta Road,Bangalore-560029