Medical Officer/Consultant

3 days ago


Mumbai, Maharashtra, India Medi Assist Full time
Designation: Medical Officer/Consultant - Non ClinicalFunction: Claims PA/RI Approver Reporting to: Assistant Manager Claims Location: Mumbai Educational Qualification: BHMS, BAMS, MBBS(Indian registration Required) Shift: Rotational Shift (for female employee shift ends at 8:30 PM) Week offs: 6 rotational week offs Provided per month Related courses attended: None Management Level: Junior Management Level Industry Type: Hospital/TPA/Healthcare/Insurance Roles and Responsibilities: 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. Key Results and Outcomes driven by this role:Error-free processing (100% Accuracy)Maintaining TATProductivity (Achieve the daily targets) Relevant Experience: 0- 5 years No. of years of experience: 0-5 years Demonstrated abilities if any: None Technical Competencies:Analytical SkillsBasic Computer knowledgeType writing skills Behavioral competencies:Communication skillsDecision MakingMore information about this Medical Officer/Consultant - Non Clinical JobPlease go through the below FAQs to get all answers related to the given Medical Officer/Consultant - Non Clinical jobWhat are the job requirements to apply for this Medical Officer/Consultant - Non Clinical job position? Ans: A candidate must have a minimum of 0 to 3+ year experience as an Medical Officer/Consultant - Non Clinical What is the qualification for this job? Ans: The candidate can be a Graduate from any of the following: MBBS, BAMS, BHMS What is the hiring Process of this job? Ans: The hiring process all depends on the company. Normally for an entry level, hiring the candidate has to go for Aptitude, GD (If they look for communication),Technical test and face to face interviews.This Medical Officer/Consultant - Non Clinical is a work from home job? Ans: No ,its not a Work from Home Job. How many job vacancies are opening for the Medical Officer/Consultant - Non Clinical position? Ans: There are immediate 1 job openings for Medical Officer/Consultant - Non Clinical in our Organisation.

MBBS, BAMS, BHMS

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