Insurance Claim Auditor/ahmedabad/doctors

19 hours ago

Ahmedabad, India MediEnsure Pvt Ltd Full time

**Job description**

**Greetings From MediEnsure Pvt Ltd**

**Job Title: Hospital Auditor**

**Qualification-BAMS/BHMS/BDS/BPT/MBA in Healthcare Management/MHA(People with any other healthcare background also can apply)**

**Primary Role**:
As a hospital auditor, the primary role is to evaluate medical claims made by hospitals to ensure that they are medically necessary and accurately billed based on the policies and protocols of the health insurer. They also play a key role in identifying and preventing fraudulent claims by cross-referencing multiple claims and reviewing medical records in detail.

**Responsibilities**:
The primary responsibilities of a hospital auditor are:
1. Conduct audits of medical claims submitted by hospitals to ensure accuracy and appropriateness.

2. Verify the medical necessity of procedures and treatments performed on patients.

3. Identify and report fraudulent billing practices.

4. Evaluate compliance with industry regulations, such as HIPAA and Medicare/Medicaid standards.

5. Analyze medical records to determine if the care provided meets industry standards and best practices.

6. Prepare reports to present audit results to hospital management and health insurer leadership.

7. Communicate with hospital staff and physicians to ensure that they are aware of the audit process and any changes to policies or procedures.

8. Provide support and guidance to hospital staff to help them understand industry regulations and billing practices.

9. Monitor and evaluate trends in claims data to inform policy changes and improve the overall efficiency and effectiveness of the health insurer's operations.

Qualifications:
The qualifications required for a hospital auditor working for a health insurer are:
1. Bachelor's degree in health care management, finance or related field.

2. Knowledge of medical billing codes and insurance industry standards.

3. Ability to read and interpret medical records and claims documents.

4. Experience conducting audits and reviewing financial statements.

5. Excellent analytical skills and attention to detail.

6. Excellent communication skills, both written and verbal.

7. Ability to work independently and within a team environment.

8. Understanding of healthcare industry regulations and quality improvement standards.

9. Proficiency in using computer and data analysis software.

**Job Type**: Contractual / Temporary
Contract length: 12 months

**Salary**: ₹360,000.00 - ₹420,000.00 per year

**Speak with the employer**
+91 8630533811

  • Insurance Claim Auditor Ahmedabad Doctors

    2 days ago

    Ahmedabad, India MediEnsure Pvt Ltd Full time

    **Greetings From MediEnsure Pvt Ltd** **Job Title: Hospital Auditor** **Primary Role**: As a hospital auditor, the primary role is to evaluate medical claims made by hospitals to ensure that they are medically necessary and accurately billed based on the policies and protocols of the health insurer. They also play a key role in identifying and preventing...

  • Back Office Executive Insurance

    19 hours ago

    Ahmedabad, Gujarat, India Tcp Corps Outsourcing llc Full time

    **Job Title: Back Office Executive - Insurance Claims** **Location: Ahmedabad** **Interview Mode - Walk-in/F2F** **Salary: 20,000 - 25,000** **Positions Available: 2** **Key Responsibilities**: - Manage insurance claims, ensuring accurate documentation and timely processing. - Organize and maintain electronic and physical files related to claims. -...

  • Non Mbbs Doctor for Health Claims Processing

    2 weeks ago

    Satellite, Ahmedabad, Gujarat, India FAMILY HEALTH PLAN INSURANCE TPA LTD Full time

    **Job Summary** MEDICAL OFFICER for TPA and INSURANCE COMPNEY **Responsibilities and Duties** CASHLESS AND REIMBURSEMENT HEALTH CLAIMS PROCESSING **Required Experience, Skills and Qualifications** BAMS/BHMS/MBBS DOCTORS Pay: ₹20,000.00 - ₹25,000.00 per month **Benefits**: - Health insurance - Leave encashment - Paid sick time - Provident...

  • Doctors Mbbs

    1 week ago

    Ahmedabad, India Doctors at Doorstep Full time

    Doctors at Doorstep is the platform where Doctors are visiting the patient's home, through this platform. Doctors are hiring on call base and getting freedom of time, area of visit and acceptance of the particular visit or decline. Doctors are getting payment of per visit 700 to 2000 for MBBS & MD. Area of visit Ahmedabad's or Gandhinagar's Particular Area...

  • Doctors Mbbs

    6 days ago

    Ahmedabad, India Doctors at Doorstep Full time

    DokVision A Care at Home is the platform where Doctors are visiting the patient's home, through this platform. Doctors are hiring on call base and getting freedom of time, area of visit and acceptance of the particular visit or decline. Doctors are getting payment of per visit 700 to 1500 for MBBS & MD. Area of visit Ahmedabad's or Gandhinagar's Particular...

  • Doctors Mbbs

    19 hours ago

    Ahmedabad, Gujarat, India Doctors at Doorstep Full time

    DokVision A Care at Home is the platform where Doctors are visiting the patient's home, through this platform. Doctors are hiring on call base and getting freedom of time, area of visit and acceptance of the particular visit or decline. Doctors are getting payment of per visit 700 to 1500 for MBBS & MD. Area of visit Ahmedabad's or Gandhinagar's Particular...

  • Doctors Mbbs

    6 days ago

    Ahmedabad, Gujarat, India Doctors at Doorstep Full time

    DokVision A Care at Home is the platform where Doctors are visiting the patient's home, through this platform. Doctors are hiring on call base and getting freedom of time, area of visit and acceptance of the particular visit or decline. Doctors are getting payment of per visit 700 to 1500 for MBBS & MD. Area of visit Ahmedabad's or Gandhinagar's Particular...

  • Doctors Mbbs

    1 week ago

    Ahmedabad, Gujarat, India Doctors at Doorstep Full time

    DokVision A Care at Home is the platform where Doctors are visiting the patient's home, through this platform. Doctors are hiring on call base and getting freedom of time, area of visit and acceptance of the particular visit or decline. Doctors are getting payment of per visit 700 to 1500 for MBBS & MD. Area of visit Ahmedabad's or Gandhinagar's Particular...

  • Back Office Executive

    1 week ago

    Satellite, Ahmedabad, Gujarat, India Engage Experts Full time

    **Job Title: Back Office Executive** **Department: Insurance - Claims** **Location**: Shivalik Shilp, Opp Iscon Temple, Iscon Cross Road, Sarkhej-Gandhinagar Hwy, Ahmedabad, Gujarat 380015 **Work Schedule**: - Monday to Friday: 9:30 AM - 6:30 PM - Saturday: 9:30 AM - 3:00 PM **Job Overview**: **Key Responsibilities**: - Manage insurance claims and...

  • Insurance Officer

    1 week ago

    Ahmedabad, Gujarat, India Qatar Airways Full time

    Job title - Insurance Officer (Ahmedabad, India) - Ref # - 250000GX - Location - India - Ahmedabad - Job family - Corporate & Commercial - Closing date: 11-Aug-2025 Qatar Airways is seeking experienced professionals for the role of **Insurance Officer** based at our Global Business Services (GBS) in Ahmedabad, India. The Insurance Officer will play a...