Medical Officer
2 days ago
Key responsibilities:
- Medical Scrutiny: Analyze medical reports and records to validate diagnoses and treatments submitted in pre-authorization requests.
- Claim Processing: Evaluate claims against policy terms, conditions, and guidelines, checking for co-pay details, room tariffs, and non-medical expenses.
- Decision Making: Authorize or deny claims based on the medical admissibility and policy rules.
- Communication: Liaise with hospitals, insurance companies, and other stakeholders to resolve discrepancies and gather necessary information.
- Documentation: Maintain accurate and detailed records of all claim interactions.
- Compliance: Ensure all actions comply with insurance regulations and company policies.
- Query Resolution: Handle and respond to queries and escalations from various parties.
Experience- 1+ year
Qualification- A medical degree such as BAMS, or BHMS is typically required.
Interested Candidates shared your CV on:
Job Type: Full-time
Pay: ₹25, ₹55,000.00 per month
Benefits:
- Health insurance
- Provident Fund
Work Location: In person
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