
Medical Officer – TPA Claim Process
3 days ago
Job Title: Medical Officer – TPA Claim ProcessDepartment: TPA / Health Insurance DeskLocation: Vadodara Reporting To: TPA Manager / Operations HeadJob Summary:The Medical Officer (TPA) will be responsible for reviewing, validating, and processing insurance (TPA) claims, ensuring medical accuracy, compliance with policy terms, and timely coordination between hospital departments, doctors, and TPA representatives.Key Responsibilities:Examine and verify patients’ medical records, treatment plans, and discharge summaries for insurance claim processing.Coordinate with treating consultants to obtain medical justifications or clarifications required by the TPA.Scrutinize pre-authorization and final bill submissions as per TPA and insurance guidelines.Ensure correctness of ICD codes, procedures, and diagnosis in the claim documents.Review claim queries and prepare appropriate medical responses or justifications.Liaise with TPA coordinators, hospital billing, and admission teams to ensure smooth cashless approval and reimbursement flow.Maintain accurate claim records and ensure timely submission of documents to TPAs.Monitor and track pending and rejected claims, ensuring resolution in coordination with the TPA team.Ensure compliance with TPA policies, medical ethics, and hospital protocols.Provide medical support to the TPA operations team for claim audits and reconciliation.Required Qualifications & Skills:MBBS / BHMS / BAMS / equivalent medical qualification (MCI-registered preferred).1–3 years of experience in hospital TPA claim processing or medical audit.Sound knowledge of health insurance policies, cashless & reimbursement claim processes.Strong analytical and documentation skills.Proficiency in MS Office and hospital management software (HMS).Good communication and coordination abilities.
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Medical Insurance Claims Processor
4 days ago
Kochi, Kerala, India Doorcaz Full time**Position Summary** We are seeking enthusiastic MBBS freshers / interns / house-surgeons (or with up to 2 years experience) to join our medical insurance claims processing team. The role involves verifying medical documents, liaising with hospitals / TPAs / insurers, reviewing claims for accuracy and completeness, and ensuring timely processing. Clinical...
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Claims Officer
1 week ago
Elamakkara, Kochi, Kerala, India Regiis Insurance Brokers Private Limited Full time**Job Summary**: The Claims Officer will be responsible for managing end-to-end claims processing, ensuring accurate and timely settlement, maintaining claims-related MIS, and assisting with underwriting tasks. The role requires coordination with insurers, clients, and internal teams to facilitate smooth claim resolution while upholding compliance and...
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Medical Officer
6 days ago
Kochi, India MEDIDESK HEALTHCARE SERVICES PVT LTD Full timeDesired profile - BAMS, BHMS, BNYS, BDS, MDS, BUMS Verify the documents required for processing claims, notify hospitals in case of insufficiency of documents. scrutinize the claims as per the terms and conditions of the insurance policy and medical admissibility **Job Type**: Permanent **Salary**: ₹300,000.00 - ₹480,000.00 per year Schedule: - Day...
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Claims Co Ordinator
2 weeks ago
Kochi, Kerala, India ZEAK US Full time**Claims Coordinator** **Location**: Pala, Kanirappilly, Kattapana, Vaikom **Salary**: Based on experience **Gender: Male** **Responsibilities**: - Manage and process claims related to vehicle repairs, damages, and insurance settlements. - Coordinate with insurance companies to ensure timely and accurate claims processing. - Liaise with customers to...
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Claims Assistant
1 week ago
Kochi, Kerala, India SAI SERVICE PRIVATE LTD (Maruti Suzuki) Full time**Claims Executive** - Support Body shop Manager for preparing vehicle records for timely processing of the insurance claims. - Communication with insurance companies for claim related requirement. Qualification: Any Degree Experience: Min 1 year **Salary**: Up to 15000 Location: Tripunithura **Job Types**: Full-time, Permanent Pay: Up to ₹15,000.00...
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Wanted Medical Coding Tutors
2 weeks ago
Kochi, India Luminis School of Medical Scribing Full timeLuminis School of Medical Scribing and Medical Coding Medical Coding Tutor / Faculty Experience : Minimum One year in Medical Coding / Medical Coding Teaching Qualification : Graduation + CPC by AAPC Locations : Kochi, Mavelikkara, Kozhikode, Perinthalmanna, Kannur Job Type : Full Time, Office Based **Salary**: From ₹20,000.00 per month Schedule: -...
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Field Officer mediclaim Verification
2 days ago
Kochi, Kerala, India Optimus Medical Services Pvt Ltd Full timeWe're looking for Field Officers to verify insurance claims **KEY RESPONSIBILITIES** - Meeting with claimant and hospitals to verify insurance claims. - Cross checking with doctors. - Maintain and improve quality of customer service by managing and developing relationships with customers. - Provide assistance with insurance related matters, including claims...
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Claims Assistant
2 weeks ago
Edapally, Kochi, Kerala, India SAI SERVICE PVT LTD(MARUTI SUZUKI ARENA) Full timeSupport Bodyshop Manager for preparing vehicle records for timely processing of the insurance claims. - Communicate with insurance companies for claim related requirement. Qualification: Any Degree Min 1 year of experience Location: Pathadipalam **Job Types**: Full-time, Permanent Pay: ₹12,000.00 - ₹17,000.00 per year **Benefits**: - Health...
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Healthcare Coordinator
2 weeks ago
Kakkanad, Kochi, Kerala, India Aries Group of Companies Full time ₹ 2,50,000 - ₹ 3,00,000 per yearJob Description:Job Title: Healthcare Coordinator (India-based)Role & Responsibilities:Coordinate patient cases remotely from India, ensuring smooth communication between patients, hospitals, and insurance/TPA partners.Support clients through the treatment life cycle — from initial inquiry to discharge.Handle documentation, medical report collection, and...
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Medical Coder
1 week ago
Kochi, Kerala, India Dynamed Healthcare Solutions Pvt. Ltd Full time**Review and analyze patient records**: Examine doctors' notes, medical documents, diagnostic reports, drug administration charts and other records ensuring that all diagnoses and procedures are properly documented. - **Assign codes**: Use ICD 10 CM (International Classification of Diseases - 2021 guidelines) and CPT (Current Procedural Terminology - 2021...