Medical Advisor

2 weeks ago


India Bloom Consulting Services Full time

NA

Experience

**2 - 5 years**

Offered Salary

Notice Period

**Not Disclosed**

JD for Dr:
Roles & Responsibilities:
1] Handling health claims/Cashless reimbursements as per the prescribed manner within the TAT

2] Verification of medical documents for justification of claims

3] Good in medical knowledge and hospital practice exposure

4] Fraud control by identifying existing claim trends & triggers management.

5] Scrutiny of Health claim as per Financial Liability, in consideration with Existing provider Tariffs.

6] Co-ordination with TPA &Insurance Company. 7] Handling the grievance related to the rejection/ denial of the Cashless request as well as re-reimbursement claims.

Skills & Competencies required for the Role:
Good Medical knowledge with claim judgment


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