Medical Claims

About Us:Medi Assist is India's leading Health Tech and Insure Tech company focused onadministering health benefits across employers, retail members, and publichealth schemes. We consistently strive to drive innovation and participate insuch initiatives, to lower health care costs.Our Health Benefits:Administration model is designed to deliver the tools...

Should possess U.S Health insurance claim processing experienceKnowledge of medical billing and coding terminologiesReady to work in Night Shift as well as Day shiftUnderstanding of plan documents and general benefitsFamiliarity with terms such as deductible, out of pocket, coinsurance, and copayStrong attention to detail and accuracyAbility to work in...

Generate Cases, Allocate Cases to field investigator on day to day activity. Medical Claim Closer by Mail and by Concerned Portal. Study and analyze the medical records forwarded by clients for investigation. Make appropriate triggers for investigation. Allocate the case to investigators in field. Monitor the investigation, being done by field...

**Urgent Opening** **Role**:Investigation Claims **Experience**:3 to 8 Years **Location**:Mumbai (Goregaon) **Industry**: Insurance **Qualification**: BAMS, BHMS, BUMS, BDS, BPT **Role & Responsibility**: (Details of the roles & responsibility) **Investigation Management (Health/CI/PA Claims)** 1. Required to assign, follow up, get the investigation...

Roles and ResponsibilitiesConduct thorough investigations into health insurance claims, including medical records review and witness statements gathering.Determine claim validity by analyzing policy terms, coverage conditions, and documentation.Coordinate with hospitals, doctors, and other stakeholders for smooth claim handling.Ensure compliance with...

Roles and ResponsibilitiesManage insurance claims from receipt to settlement, ensuring timely and accurate processing.Conduct thorough analysis of claim documents, including medical records, police reports, and other relevant documentation.Identify potential fraud risks and take necessary actions to mitigate them.Collaborate with internal stakeholders, such...

**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 organization while settlement...

Hiring Claims Executive for billing of medical claims. Candidate must have experience in tpa industry.

Should possess U.S Health insurance claim processing experience Knowledge of medical billing and coding terminologies Ready to work in Night Shift as well as Day shift Understanding of plan documents and general benefits Familiarity with terms such as deductible, out of pocket, coinsurance, and copay Strong attention to detail and accuracy Ability to work in...

Medical Scrutiny - Provide Medical opinion for Health Insurance Claims - Processing of Cashless Requests & Health Insurance Claim Documents - Proficient with medical terms & system. - Understanding of Policy terms & conditions & Various Protocols / Guidelines - Understanding of Claims adjudication / Claims Processing - Maintaining & Ensuring Standard...