Medical Officer
4 months ago
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.
- verify the necessary details accordingly.
- Verify the required documents for processing claims and raise an IR in case of an insufficiency.
- Approve or deny the claims as per the terms and conditions within the TAT.
Handle escalations and responding to mails accordingly.
To complete target. To work as a team.
**Job Types**: Full-time, Permanent
Pay: Up to ₹25,000.00 per month
**Benefits**:
- Paid sick time
Schedule:
- Day shift
- Morning shift
**Education**:
- Bachelor's (preferred)
**Experience**:
- total work: 1 year (preferred)
**Location**:
- Bhopal, Madhya Pradesh (preferred)
Work Location: In person
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