Medical Officer(Claims)

Greeting from Medi assist TPA Pvt ltd.Hiring Medical officer for Insurance Claim processing ProfileLocation- Mumbai -Andheri East.Role - Medical officer Exp : 0-3 yearsWORK FROM OFFICE ONLY.Job description :Check the medical admissibility of a claim by confirming the diagnosis and treatment details.Scrutinize the claims, as per the terms and conditions of...

Key Responsibilities:Oversee and manage health claim operations (cashless, reimbursement, and PA claims) across the assigned state.Ensure adherence to TATs, quality standards, and claim handling guidelines.Supervise, train, and support a team of field investigators, medical reviewers, and coordinators.Monitor daily case allocation, field visit performance,...

Medical Claims Review:Analyze and assess pre-authorization and post-treatment reimbursement claims.Review medical records, diagnosis, investigation reports, and treatment plans to ensure clinical appropriateness and policy alignment.Validate claims based on insurance policies, internal guidelines.Decision Making:Determine the admissibility or rejection of...

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 policyInterpret 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...

Claims Processing DrJob Qualifications and Requirements:Required : BDS, BHMS, BAMS, MD, Pharm D Graduates.Job Description:Along with the medical expertise, need to master the various products ( Policies) and to apply the terms and conditions during claim processing.Claims processors process any claim payments when applicable and must ensure they comply with...

Job Summary:We are seeking a qualified and experienced medical professional with a strong background in health insurance claim settlement and customer service. The ideal candidate will leverage their clinical knowledge to evaluate and process health insurance claims efficiently while ensuring a high level of customer satisfaction. This hybrid role bridges...

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...

Designation: Senior Medical OfficerFunction: Claims PA/RI ApproverReporting to: Assistant Manager/ManagerLocation: Andheri East, MumbaiEducational Qualification: BAMS, BHMS, BPT, MBBS, BSc. NursingAdditional Qualification: NoneSpecialization: General MedicineRelated courses attended: NoneManagement Level: Junior Management LevelIndustry Type:...

Company DescriptionParamount Health Services & Insurance TPA Pvt. Ltd. (PHS) is a Third Party Administrator in the health insurance sector, serving all insurance companies. PHS enhances health insurance policies through a network of healthcare service providers, medical care standardization, claims management, client servicing, and expert opinion, thereby...

As a Medical Coordinator - Claim Processing, your role involves verifying and processing insurance claims, ensuring accuracy in medical information capture, and facilitating communication among insurance companies, healthcare professionals, and patients. Your responsibilities will include: - Reviewing and processing medical insurance claims - Ensuring...