Medical Officer

1 week ago

Bengaluru, Karnataka, India Karthika Consulting & Solutions Full time ₹ 9,00,000 - ₹ 12,00,000 per year

Role & responsibilities

  • Play as an intermediate role Between the Insurance co. and Hospital and We Assist Team.
  • Adjudicating cashless and Reimbursement claims with claim documents provided by help desk executive.
  • Should be able to do claim tabulation to bifurcate payable and non-payable items as per the terms and conditions laid out in the insurance policy.
  • Evaluating claims and posting remarks in whats app group and updating in CRM.
  • Monitoring billing as per the Tariff.
  • Managing claims escalations from hospitals.
  • Responsible to handling queries raised by insurance company / TPAs
  • Provide technical assistance and conduct training sessions for new processors on various health insurance policies.
  • Evaluate complete claim documents before submission.
  • Final Approval of Tabulation done by the team
  • Coordinate with Internal team to understand patient enquiries.
  • Helping team to understand the Non-medical Items.
  • Periodically educating claim assistance department about the changes in the policy, rules & regulations and application deduction on settlement.
  • To create awareness about reimbursement claims. (Pre, Post & Hospitalization) and communicating the important updates to the Claims Assistance and Finance Department
  • Be available at the office for supporting onsite staff on all six days in a week b/w 9.30am to 7.00pm
  • Efficiently and effectively handle grievance / issue raised by hospital staff & patients, escalate issue to the team leader, Manager Insurance Adjudication and Business Head as necessary.
  • Follow-up on the updates to be given to the clients / onsite team of Claims Assistance Department

Qualifications & Skills.

  • BAMS / BHMS / BDS / Bsc / MSc / Nursing / Dpharm / Bpharm
  • 5-8 years of relevant experience
  • Should have good analytical skills
  • Excellent interpersonal & communication skills

Experience.

  • 5-8 years of experience in TPA or Indian Insurance claims or similar field or fresher

Additional Skills.

  • Strong verbal skills Fluency
  • Strong problem-solving skills and enthusiasm for new tasks and challenges
  • Relationship building skills.
  • Ability to multitask and prioritize, with a strong work ethic and attention to detail
  • Ability to operate with a high level of confidentiality and professionalism
  • A willingness to accept a high degree of uncertainty, jump in and help wherever needed, get hands dirty, and wear multiple hats on a fast-moving team.
  • Should be able to manage the task assigned, while managing the tasks of the team/ team members that are assigned
  • Should have an ability to manage and maintain smooth relationship with cross functional department such as Finance, Claims Assistance, Back-Office and Marketing Team

  • Medical Officer

    2 weeks ago

    Bengaluru, Karnataka, India Vcare Health Clinic Pvt Ltd Full time ₹ 70,000 - ₹ 8,40,000 per year

    *Job description for Medical Officer• Qualification: MBBSAdministering treatments, monitoring outcomes and recommending changes in treatment plans when necessary for Hair & Skin.Educating patients on lifestyle choices and other ways to improve their conditionsReferring patients to alternative specialists for treatmentsEnsuring that all procedures are in...

  • Medical Officer

    8 hours ago

    Bengaluru, Karnataka, India Navi Full time ₹ 5,00,000 - ₹ 15,00,000 per year

    About the Team  The Claims team at Navi is responsible for delivering a fast, transparent, and customer-first claims experience. From initial intimation to final settlement—whether cashless or reimbursement—they manage the end-to-end process with a strong focus on accuracy and turnaround time. The team works closely with the Hospital Partnerships...

  • Medical Officer

    2 weeks ago

    Bengaluru, Karnataka, India Azim Premji Foundation Full time ₹ 6,00,000 - ₹ 18,00,000 per year

    Inviting passionate MBBS doctors to serve vulnerable communities in Bengaluru.We are working to improve the health of the underserved communities living in urban settlements of Bengaluru.Since 2022, we have started an integrated community health program across 5 locations in Bengaluru. At each location, we have our Health Centre and a team of Community...

  • Resident Medical Officer

    2 days ago

    Bengaluru, Karnataka, India Docthub Jobs Full time ₹ 8,00,000 - ₹ 24,00,000 per year

    Diagnose and treat a wide range of medical conditions and illnesses.Provide immediate medical care in emergencies and urgent situations.Conduct thorough patient examinations and medical histories.Prescribe medications and treatments as necessary.Languages:English, Kannada and Hindi- Candidates with the ability to work as a General Family Physician are...

  • Resident Medical Officer

    1 week ago

    Bengaluru, Karnataka, India Lifebridge Senior Care Full time ₹ 12,00,000 - ₹ 36,00,000 per year

    Position SummaryThe Resident Medical Officer (RMO) is responsible for delivering comprehensive medical care to elderly patients within the geriatric care facility. The role includes clinical diagnosis, treatment planning, emergency care, and coordination with the interdisciplinary healthcare team. The RMO plays a vital role in ensuring personalized and...

  • Senior Medical Officer

    4 days ago

    Bengaluru, Karnataka, India Vidal Health Insurance Full time ₹ 5,00,000 - ₹ 12,00,000 per year

    The team of medical practitioner part of Pre-Authorization team will use their skills and expertise in authorizing the request received and they will ensure that the customers are attended on time by following the protocol of the policy defined by the insurer and the organization.Ensuring error free processing of preauthorisation within agreed TAT...

  • Medical Officer(Whitefield)

    4 days ago

    Bengaluru, Karnataka, India Sukino Healthcare Solutions Full time ₹ 18,00,000 per year

    Qualification-MBBSExperience yrsLocation-Whitefield Shift- Day shift( 10 AM to 06PM)CCF Clients' Admission Process - Active participation in the clients' admission process at the Continuum Care Facility, from a medical, holistic & continuum care point of view, understanding the needs of the client and the scope of services needed.The admission process at...

  • Medical officer Tele

    6 days ago

    Bengaluru, Karnataka, India Grace Multitrading Company Full time ₹ 3,60,000 - ₹ 4,20,000 per year

    Hiring BHMS/ BAMS/ BDS Graduates for a Leading Insurance Company – BangalorePosition: Tele & Video Medical ReviewerJob Type: Full-TimeWork Mode: Work from OfficeLocation: BangaloreExperience Required: Minimum 1 year in Tele & Video Medical ReviewJob Description:We are hiring qualified medical professionals (BHMS / BAMS / BDS) to join a reputed insurance...

  • Medical Officer

    1 week ago

    Bengaluru, Karnataka, India Navi Technologies Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    About the TeamThe Claims team at Navi is responsible for delivering a fast, transparent, and customer-first claims experience. From initial intimation to final settlement, whether cashless or reimbursement, they manage the end-to-end process with a strong focus on accuracy and turnaround time. The team works closely with the Hospital Partnerships team to...

  • Duty Medical Officer

    4 days ago

    Bengaluru, Karnataka, India Athulya Senior Care Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    At Athulya, we cherish diversity as our greatest asset. The unique backgrounds, experiences, and perspectives of our team members are the rhythms that drive our innovative approach. We are committed to an inclusive culture because it enables us to craft solutions that benefit all. Treating every candidate with equality and fairness is not just a policy; it's...