Medical Officer

6 months ago


Andheri East Mumbai Maharashtra, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time

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.

**Job Types**: Full-time, Permanent

Pay: ₹320,000.00 - ₹450,000.00 per year

**Benefits**:

- Health insurance
- Paid sick time
- Provident Fund

Schedule:

- Day shift

Supplemental pay types:

- Performance bonus

**Education**:

- Bachelor's (preferred)

**Experience**:

- Clinical: 1 year (required)

Work Location: In person


  • Medical Officer

    6 months ago


    Andheri East, Mumbai, Maharashtra, India Paramount Healthcare Management Pvt Ltd Full time

    Paramount is presently servicing more than 50 lakh lives managing Corporate and Individual Policies and an additional 4 crores lives managing State Government Health Policies. Recipient of 'TPA of the Year' award for two consecutive years at the India Insurance Summit & Awards (2018 & 2019) We are hiring doctors for medi - claim processing hence medically...

  • Medical Officer

    6 months ago


    Andheri East, Mumbai, Maharashtra, India Paramount Healthcare Management Pvt Ltd Full time

    Paramount is presently servicing more than 50 lakh lives managing Corporate and Individual Policies and an additional 4 crores lives managing State Government Health Policies. Recipient of 'TPA of the Year' award for two consecutive years at the India Insurance Summit & Awards (2018 & 2019) We are hiring doctors for medi - claim processing hence medically...

  • Medical Officer

    6 months ago


    Andheri East, Mumbai, Maharashtra, India Paramount Healthcare Management Pvt Ltd Full time

    Paramount is presently servicing more than 50 lakh lives managing Corporate and Individual Policies and an additional 4 crores lives managing State Government Health Policies. Recipient of 'TPA of the Year' award for two consecutive years at the India Insurance Summit & Awards (2018 & 2019) We are hiring doctors for medi - claim processing hence medically...

  • Medical Officer

    6 months ago


    Andheri East, Mumbai, Maharashtra, India Paramount Healthcare Management Pvt Ltd. Full time

    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...

  • Medical Officer

    6 months ago


    Andheri, Mumbai, Maharashtra, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time

    Greetings From Medi assist Company!! Hurry up Medi assist is Hiring Medical officer for Full time Job in Mumbai. Role/Position: Permanent Experience: looking for TPA background and clinical experience in health insurance. Education: BAMS,BDS ,BUMS, BHMS,BPT MPT & Bsc nursing. Shifts: Day shift Rotational 6 days working ( work from office) Job role :...

  • Medical Officer

    6 months ago


    Andheri, Mumbai, Maharashtra, India Tresbien HR Consultancy Full time

    **Job Summary** Hi Urgent Opening for Medical Officer with a leading TPA at Andheri Marol **WORK FROM OFFICE ONLY** Location -Andheri Vacancy - 1 **Responsibilities**: - Understanding of Policy terms & conditions & Various Protocols / Guidelines - Maintaining & Ensuring Standard Operating Procedures & Protocols Ailment Wise ICD & Procedure Coding -...

  • Medical Officer

    1 month ago


    Andheri, Mumbai, Maharashtra, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time

    **Job description** **Role**:Medical Officer** **Work from Office only** **Job Descriptions**: - **To approve Claims based on the buckets allotted to each approver.**: - **To inform the Network department in case of any erroneous billing / excess billing.**: - **To approve online preauthorization requests received.**: - **In case of any suspicious...


  • Nashik, Maharashtra, India Nimai Institute of Medical Sciences Pvt Ltd Full time

    Resident Medical officer Job Description **Job Overview**: We are seeking a highly capable medical officer to manage our medical team and to supervise the healthcare services that they provide. In this role, your duties will include serving as a clinical advisor, overseeing clinical trials, and maintaining high standards of inpatient care. To ensure...


  • Nashik, Maharashtra, India Nimai Institute of Medical Sciences Pvt Ltd Full time

    **Resident Medical Officer Job Description** We are seeking a highly capable Resident medical officer to manage our medical team and to supervise the healthcare services that they provide. In this role, your duties will include serving as a clinical advisor, overseeing clinical trials, and maintaining high standards of inpatient care. To ensure success,...

  • Medical Officer

    6 months ago


    Andheri, Mumbai, Maharashtra, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time

    Greetings From Medi assist Company!! Hurry up Medi assist is Hiring Medical officer for Full time Job in Mumbai. Role/Position: Permanent Education: BAMS,BDS ,BUMS, BHMS,BPT ,MPT,MDS,MBBS,BPharma,Mpharma Shifts: Rotational Shifts ( work from office) Job role: To approve PAs based on the buckets allotted to each approver To inform the Network department...

  • Medical Officer

    3 months ago


    Andheri East, Mumbai, Maharashtra, India Paramount Healthcare Management Pvt Ltd. Full time

    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...

  • Back Office Executive

    6 months ago


    Andheri East, Mumbai, Maharashtra, India Dr Belanis Blue Shield Medical Clinic LLP Full time

    Wanted a Back office assistant with good knowledge of computers, MS Office and should be able to work in team. Dedicated, hardworking individuals are welcome with appropriate renumeration. Salary is not a constraint for right individual. Its a Medical diagnostic center and working hours are from Monday to Saturday 9 am to 6.30 pm. Looking fo someone...

  • Medical Officer

    6 months ago


    Andheri, Mumbai, Maharashtra, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time

    Greetings From Medi assist Company!! Hurry up Medi assist is Hiring Medical officer for Full time Job in Mumbai. Role/Position: Permanent Education: BAMS,BDS ,BUMS, BHMS,BPT ,MPT,MDS,MBBS,BPharma,Mpharma Shifts: Rotational Shifts ( work from office) Job role: To approve PAs based on the buckets allotted to each approver To inform the Network department...


  • Bandra East, Mumbai, Maharashtra, India Asian Heart Institute Full time

    **Position** An integral role focusing on managing the Medical Records Department (MRD), ensuring adherence to quality standards (ISO), and maintaining accurate medical records in compliance with ICD-10 coding. This position also involves reporting to the Medical Director, conducting medical audits, training staff, and interacting with patients, relatives,...


  • Nashik, Maharashtra, India Nimai Institute of Medical Sciences Pvt Ltd Full time

    **Resident Medical Officer Job Description** We are seeking a highly capable Resident medical officer to manage our medical team and to supervise the healthcare services that they provide. In this role, your duties will include serving as a clinical advisor, overseeing clinical trials, and maintaining high standards of inpatient care. To ensure success,...

  • Tpa - Medical Officer

    2 months ago


    Andheri, Mumbai, Maharashtra, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time

    **Job description** **Role**:Medical Officer** **Work from Office only** **Job Descriptions**: - **To approve Claims based on the buckets allotted to each approver.**: - **To inform the Network department in case of any erroneous billing / excess billing.**: - **To approve online preauthorization requests received.**: - **In case of any suspicious...

  • Medical Officer

    6 months ago


    Mumbai, Maharashtra, India jobZsearch Full time

    **Job description** - supervision of proper implementation of health care activities in mobile medical unit - provide preventive, promotive & curative care to the community - referral of complicated cases to higher health facilities with adequate facilities - ensure de-worming & immunization awareness - supervision of other staff functions & act as overall...

  • Medical Officer

    6 months ago


    Mumbai, Maharashtra, India HealthAssure Pvt Ltd. Full time

    **Basic Responsibilities -** - Call prospective customer of insurer for taking medical history through structured tele medical interview. - Ask reflex questions in case of any medical adversity. - Take complete details of investigation and treatment completed by customer. - Doctors will be working from office. **Skills -** **BAMS / BHAMS / BDS** **Job...

  • Medical Representative

    6 months ago


    Andheri East, Mumbai, Maharashtra, India Career Choice Solution Full time

    Medical Receptionist Job Responsibilities: Serves patients by greeting and helping them, scheduling appointments, and maintaining records and accounts. Receive, sort and distribute daily mail/deliveries Maintain office security by following safety procedures and controlling access via the reception desk (monitor logbook, issue visitor badges) Order front...

  • Medical Officer

    7 months ago


    Mumbai, Maharashtra, India Fusion Business Solutions Pvt. Ltd. Full time

    We are seeking a dedicated and compassionate Medical Officer to join our team. This position offers an excellent opportunity for a recent medical graduate to gain valuable experience in a supportive environment. **Responsibilities**: - Conduct routine medical examinations and assessments of patients. - Diagnose and treat common medical conditions,...