Claims Doctor

TPA / Health Insurance Exp. is preferredAssessment of Health Claims Assessment of Treatment & Medication given in the papers sent for claim Cost optimizationApproval of Claims for ProcessingMBBS , BHMS & BAMS Doctors only

PositionMBBS DoctorLocation: HyderabadReporting To: MD&CEO / VPPosition Overview:To guide, lead, and develop a team of claim adjudication in line with Standard Operating Procedure (SOP), handling reimbursement, cashless medical claims for line-of-treatment, investigations, stay, and treatment prescribed with medical/surgical interventions. Prepare Strategic...

for Health Reimbursement Claims Processing doctor.Medical Evaluation and DocumentationExamine claim documents and understand detailed clinical findings.Document diagnoses, treatment plans, and procedures done clearly.Ensure medical records are accurate and complete for claim submission.Certification and VerificationCertify the necessity of treatments or...

Responsible for calling Insurance companies (in US) on behalf of doctors/physicians and following outstanding Accounts Receivable.To prioritize the pending claims for calling from the aging basket.Should be able to convince the claims company (payers) for payment of their outstanding claims.To check the appropriateness of the insurance information given by...

Job Summary:We are seeking a detail-oriented and organized Insurance Billing Executive to handle medical insurance claims, billing, and reimbursement processes. The role involves coordinating with patients, insurance companies, and internal teams to ensure accurate and timely claim submission, follow-up, and payment posting.Key Responsibilities:Process...

Job descriptionDuties and Responsibilities:1) Follow up with payer to check on claim status with better use of Web portals.2) Responsible for calling Insurance companies on behalf of doctors and follow up on theoutstanding accounts.3) Prioritize the pending claims for calling from the aging bucket.4) Identify denial reason and work on the resolution.5)...

R1 RCM India is proud to be a Great Place To Work Certified organization which clearly states the culture and employee centric approach. Great Place To Work (GPTW) partners with more than 11,000 organizations annually across over 22 industries and assesses organizations through an employee survey on key parameters such as trust, pride, camaraderie, and...

Key Responsibilities:Review prescriptions to assess whether the diagnosed disease/condition is covered under the customer's insurance policy Perform basic quality checks on prescriptions including: ○ Verifying doctor's name, registration ID, and specialization. ○ Ensuring mandatory details are present (diagnosis, medicines prescribed, patient...

Medical Records Management:Collect, organize, and maintain patient medical records and health information.Ensure all records are accurate, complete, and up-to-date.Retrieve records promptly for physicians, nurses, and authorized personnel.Coding and Classification:Assign medical codes (ICD-10, CPT) to diagnoses and procedures for billing and statistical...

Role Description:The Scientific Communications MLR Technical Reviewer is responsible for checking all medical content for data and scientific accuracy, and reference appropriateness for materials submitted through the Medical, Legal, and Regulatory (MLR) process. This role ensures that all content adheres to Amgens scientific and compliance standards, while...