Medical Officer Walk in Interview Working From

8 hours ago

Bannerghatta Road Bengaluru Karnataka, India MEDI ASSIST INSURANCE TPA PRIVATE LIMITED Full time

Designation: Medical Officer/Senior Medical Officer

Function: Claims PA/RI Approver

Location: Bangalore

Educational Qualification

BHMS,BAMS, BDS, MBBS.

Industry Type: Hospital/TPA/Healthcare/Insurance

Roles and Responsibilities:

- 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.

Key Results and Outcomes driven by this role:

- Error-free processing (100% Accuracy)
- Maintaining TAT
- Productivity (Achieve the daily targets)

Relevant Experience:0- 2 years

No of years of experience:0-3 years

Technical Competencies:

- Analytical Skills
- Basic Computer knowledge
- Type writing skills

Behavioral competencies:

- Communication skills
- Decision Making

Pay: ₹300,000.00 - ₹500,000.00 per year

Schedule:

- Day shift
- Rotational shift

**Education**:

- Bachelor's (required)

**Experience**:

- total work: 1 year (preferred)

Work Location: In person

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