Medical Officer

1 week ago

Noida Uttar Pradesh, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time

Greetings From Medi Assist

**Job Title**: Medical Officer

**Role/Position**: Permanent

**Education**: BAMS, BHMS

**Shifts**: Rotational Shifts ( work from office)

**Job location**: Noida/ Mumbai

**Job role**:

- 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

Pay: ₹300,000.00 - ₹400,000.00 per month

**Benefits**:

- Health insurance
- Provident Fund

Application Question(s):

- What is your current CTC?
- What is your expected CTC?

Work Location: In person

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