Medical Officer-claims Processing

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...

Job Title: Medical Officer Location: Bangalore Company: Medverve Healthcare Pvt Ltd Experience: 0-12 months Qualification: BAMS/ BHMS/ BDS About Us: MedVerve is co-Founded and run by a core team of qualified professionals from Healthcare Industry, with experience in Insurance Companies, TPAS, Hospitals and IT Healthcare. Bringing in strong skills in...

Job Summary **Qualifications**: - Degree in BAMS, BHMS, BSMS, or MBBS (strictly required). - Roles & Responsibilities: - Ensuring accuracy and compliance in medical claims adjudication. **Knowledge & Skill Requirements**: - Technical Competencies: - Claims processing - Preauthorization, Medical Adjudication, and Billing experience. - Understanding of...

Job Title**: Medical officer** Location: Konankunte cross Job Summary **Qualifications**: - Degree in BAMS, BHMS, BSMS, or MBBS (strictly required). - Roles & Responsibilities: - Ensuring accuracy and compliance in medical claims adjudication. **Knowledge & Skill Requirements**: - Technical Competencies: - Claims processing - Preauthorization,...

JOB DESRCIPTION: The role involves auditing claims and preauthorization, to ensure clinical appropriateness, policy compliance, and correct system processing. It requires a strong blend of medical understanding and system knowledge to identify errors, investigate their root causes, and support in improvement of workflows. **Key Responsibilities** 1.Review...

The team of medical practitioner part of Pre-Authorization team/ Claims will use their skills and expertise in authorizing the request received and they will ensure that the customers are attended on time by following the protocol of the policy defined by the insurer and the organization. Medical practitioner/BDS/BHMS/BAMS/ MBBS. Ensure 100% accuracy of...

Claim registration - On Daily Basis need to register the claims which has been assigned for processing, Scrutiny of the documents - Reserve Setting: - Need to do the proper reserve setting on system based on the claim documents - Technical processing claims which has been assigned for processing for health/ personal accident etc claims and deductions of...

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...

Job Description: Position Overview : The claim officer is responsible for reviewing, processing, and making recommendations on health insurance claims. The incumbent will ensure that claims are processed in accordance with company policies, procedures, and regulatory requirements. Key Responsibilities: - Review and analyze health insurance claims for...

**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...