Medical Officer

14 hours ago


Bengaluru Karnataka, India Medverve Healthcare Full time

Job Title: Claim Quality Analyst

Location: Bangalore

Company: Medverve Healthcare Pvt Ltd

Experience: 0-12 months

Qualification: MSC, B.Pharma, M.Pharma

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 Health Insurance, Payor Domain, Strategic Planning, Provider Process, Technology, Operations and Customer Management.

Key Responsibilities:

- Good communication skill.
- Knowledge in computers like MS office.
- Good medical knowledge.
- Independently process Post hospitalization claims; process complex claims with mínimal assistance
- Needs to validate the information on all medical claims received. Claims must be thoroughly reviewed and ensure that there is no missing or incomplete information
- Suggest operational policies, workflows and process improvement initiatives
- Proactive approach by informing Providers regarding missing or repetitive errors by various hospital departments and improvisation of the same.
- Application of medical knowledge to bifurcate the claims.
- Analyzing and justifying the care and management given to the patient
- Thorough understanding of medical terminology in relation to diagnosis and procedures and meeting daily targets.
- Updating skills and medical knowledge with routine enhancement programs.
- Adjudication of claims as per the office memorandum of the concern scheme protocols
- Responsible for the accurate and timely processing of post discharge cashless claims.
- Meets quantity and quality claims processing standards.
- In-depth understanding of the hospitals processes, policies and procedures

Verify Medical, billing related documents for further claim processing.

What We Offer:

- Opportunities for professional development and career advancement.
- A collaborative and dynamic work environment.

Pay: ₹18,000.00 - ₹20,000.00 per month

**Benefits**:

- Health insurance
- Leave encashment
- Provident Fund

Schedule:

- Morning shift

Supplemental Pay:

- Yearly bonus

Application Question(s):

- Experience as Claims Analyst

**Location**:

- Bangalore, Karnataka (preferred)

Work Location: In person

Expected Start Date: 03/03/2025


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