Medical Officer

1 week ago

Bengaluru, Karnataka, India MedVerve Healthcare Pvt Ltd Full time ₹ 12,00,000 - ₹ 24,00,000 per year

Qualification and Experience:

Education: BDS/ BAMS/ BHMS/ BMBS

Experience: 4+ Year of experience in claim processing, quality assurance or audit in a health insurance or TPA setup.

Job Summary:

The Medical Officer Revenue Assurance is responsible for ensuring accuracy, compliance, and efficiency in the insurance claim process through structured quality audits, SOP implementation, and continuous process improvement. The role is to lead the successful implementation of revenue cycle solutions ensuring that the system supports front-end, mid-cycle, and back-end processes across healthcare organizations. You act as a bridge between clinical, financial, and technical teams, leveraging deep domain knowledge to ensure revenue optimization and compliance.

Key Skills:

RCM knowledge: Deep knowledge of healthcare RCM lifecycle, Charge capture, Coding, Billing, Denials, Payer rules.

Soft skills: Communication, critical thinking, documentation, stakeholder engagement.

Key Responsibilities:

Serve as the RCM expert for internal teams and clients.

Provide guidance on best practices for registration, eligibility, charge capture, coding, billing, collections, and denial management.

Ensure adherence to healthcare regulations.

Lead RCM system implementations for hospitals, physician groups, or health systems.

Define and document business and functional requirements based on client goals and workflows.

Collaborate with configuration teams to build system components such as claims logic, edits, fee schedules, payer rules.

Analyze existing client workflows and identify areas for improvement.

Map out optimized processes across the revenue cycle, from patient intake to collections.

Ensure alignment between clinical documentation and financial outcomes like accurate charge capture and compliant coding.

Oversee end-to-end testing for RCM functionalities

Conduct root cause analysis for issues in claims processing or denials.

Support go-live events with onsite or virtual assistance, ensuring smooth transition and adoption.

Educate client teams (front office, HIM, billing, coders) on new system workflows.

Deliver tailored training sessions and create documentation, manage change adoption and help teams adjust to new processes.

Develop dashboards or KPIs for RCM performance such as Days in A/R, Clean Claim Rate, Denial Rate.

Provide post-implementation support and optimization recommendations.

Provide post-implementation support and optimization recommendations.

Partner with revenue cycle stakeholders (registration, billing, coding, finance, IT) to understand business needs.

Gather, document, and analyze functional requirements for improvements to RCM systems and processes.

Translate business needs into system solutions or process changes.

Map current RCM workflows across front-end (e.g., eligibility checks), mid-cycle (e.g., coding), and back-end (e.g., collections).

Identify inefficiencies, revenue leakage, or compliance gaps.

Recommend changes to streamline operations and improve reimbursement.

Build dashboards or regular reports for operational leadership.

Assist with testing, validation, and post-implementation support.

Analyze system configuration issues that impact billing, claims, or reporting accuracy.

Help translate technical concepts into business-friendly language

  • Medical Officer

    22 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

    5 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

    5 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...

  • Medical Officer

    22 hours ago

    Bengaluru, Karnataka, India Ohealer Healthcare Services Pvt Ltd Full time ₹ 8,40,000 - ₹ 9,60,000 per year

    About ClinikkWe are dedicated to democratizing healthcare through technology - ensuring families get high-quality healthcare whenever they need it.Backed by marquee investors like Rajan Anandan, 500 Startups, Times Internet, WEH Ventures, EMVC, First Principles, we are transforming healthcare for Middle India by coupling primary care and comprehensive health...