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...

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...

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...

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...

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...

Roles and ResponsibilitiesHandle health claims from receipt to settlement, ensuring timely processing and quality service delivery.Conduct thorough analysis of medical records, bills, and other relevant documents to determine claim validity.Maintain accurate records of all interactions with policyholders, agents, and other stakeholders throughout the claims...

Roles and ResponsibilitiesConduct thorough reviews of medical records, claims submissions, and other relevant documents to determine accurate payment amounts.Analyze complex healthcare data to identify trends, patterns, and areas for improvement in claims processing.Collaborate with internal stakeholders to resolve claim discrepancies and ensure timely...