Openings-bds-clinical Claims Reviewer

**Job description**: **Roles and Responsibilities** 01. Involves Processing of Claims ( Preauthorization / Reimbursement claims) 02. Validating and processing these claims within TAT 03. With good communication and medical Knowledge 04. TPA Experience is an added advantage **Financial**: To see to that there is no financial implication for the...

**Job description** **Roles and Responsibilities** 01. Involves Processing of Claims ( Preauthorization / Reimbursement claims) 02. Validating and processing these claims within TAT 03. With good communication and medical Knowledge 04. TPA Experience is an added advantage **Financial**: To see to that there is no financial implication for the...

Position: - Medical Review Scientist (BDS) Looking for a Medical Review Scientist (BDS Doctor) to join our team. Training period: 6 months During training period: 25,000/- as stipend **Job Types**: Full-time, Fresher Pay: ₹400,000.00 - ₹600,000.00 per month **Benefits**: - Cell phone reimbursement Schedule: - Day shift Supplemental pay...

Responsibilities: - Processing of Claims with verification and settlement with customer accounts. - Claim adjudication under strict adherence to hospital tariff and policy terms. - Communicating with insurance agents and beneficiaries. - Preparing claim forms and related documentation. - Reviewing claim submissions and verifying the information. - Recording...

**Job description** **Roles and Responsibilities** 01. Involves Processing of Claims ( Preauthorization / Reimbursement claims) 02. Validating and processing these claims within TAT 03. With good communication and medical Knowledge 04. TPA Experience is an added advantage **Financial**: To see to that there is no financial implication for the...

**Job description**: **Roles and Responsibilities** 01. Involves Processing of Claims ( Preauthorization / Reimbursement claims) 02. Validating and processing these claims within TAT 03. With good communication and medical Knowledge 04. TPA Experience is an added advantage **Financial**: To see to that there is no financial implication for the...

**Job Title: Clinical Reviewer** **Responsibilities**: - Evaluate and analyze medical records for completeness, accuracy, and adherence to clinical protocols. - Ensure compliance with regulatory standards, industry guidelines, and organizational policies. - Collaborate with healthcare teams to address documentation deficiencies and implement...

**Job Title: Clinical Reviewer** **Responsibilities**: - Evaluate and analyze medical records for completeness, accuracy, and adherence to clinical protocols. - Ensure compliance with regulatory standards, industry guidelines, and organizational policies. - Collaborate with healthcare teams to address documentation deficiencies and implement...

**Job Title: Clinical Reviewer** **Responsibilities**: - Evaluate and analyze medical records for completeness, accuracy, and adherence to clinical protocols. - Ensure compliance with regulatory standards, industry guidelines, and organizational policies. - Collaborate with healthcare teams to address documentation deficiencies and implement...

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...

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...

Responsibilities Experienced Medical Data Reviewer (MDR) for our clinical research team. Perform in-depth medical data review to assess data accuracy, subject safety, and protocol compliance, with emphasis on oncology therapeutic areas incl. non-small cell lung cancer, small cell lung cancer, malignant melanoma etc. Perform Risk-Based Monitoring (RBM) and...

Clinical Nurse Reviewer I- Home based - Chennai/ Bangalore ICON plc is a world-leading healthcare intelligence and clinical research organization. We’re proud to foster an inclusive environment driving innovation and excellence, and we welcome you to join us on our mission to shape the future of clinical development We are currently seeking a Clinical...

**Company Description** We are the company that cares - for our staff, for our clients, for our partners and for the quality of the work we do. A dynamic, global company founded in 1995, we bring together more than 2,000 driven, dedicated and passionate individuals. We work on the frontline of medical science, changing lives, and bringing new medicines to...

ResponsibilitiesExperienced Medical Data Reviewer (MDR) for our clinical research team.Perform in-depth medical data review to assess data accuracy, subject safety, and protocol compliance, with emphasis on oncology therapeutic areas incl. non-small cell lung cancer, small cell lung cancer, malignant melanoma etc.Perform Risk-Based Monitoring (RBM) and...

**Key Responsibilities**: - Conduct **Risk-Based Monitoring (RBM)** and Centralized Monitoring to identify data trends and potential risks early, addressing them proactively with relevant study teams. - Support **SAE reconciliation, coding review, lab data analysis**, and ensure regulatory compliance across trials. - Utilize tools such as **TIBCO Spotfire...

About Navi Navi is one of the fastest-growing financial services companies in India providing Personal & Home Loans, UPI, Insurance, Mutual Funds, and Gold. Navi's mission is to deliver digital-first financial products that are simple, accessible, and affordable. Drawing on our in-house AI/ML capabilities, technology, and product expertise, Navi is...

About Navi Navi is one of the fastest-growing financial services companies in India providing Personal & Home Loans, UPI, Insurance, Mutual Funds, and Gold. Navi's mission is to deliver digital-first financial products that are simple, accessible, and affordable. Drawing on our in-house AI/ML capabilities, technology, and product expertise, Navi is dedicated...

Omega Healthcare Management Services Private LimitedKARNATAKAPosted On - 14 Nov 2024 - End Date - 28 Nov 2024 - Required Experience - 1 - 3 Years Basic SectionNo. Of Openings 7 Grade 1B Designation MEDICAL REVIEWER Closing Date 28 Nov 2024 - OrganisationalCountry IN State KARNATAKA City BENGALURU Location Bengaluru-II -...

Job Overview Provide management and service delivery excellence of (Clinical Event Validation and Adjudication) CEVA, OGM (Oversight Group Management) projects, as assigned by CEVA Management, covering single or multiple CEVA-OGM functions, with supervision from project oversight. Provide administrative coordination for Oversight Groups (Data Monitoring...