Consultant Medical Officer

1 week ago

Bengaluru, Karnataka, India Medi Assist Full time ₹ 5,00,000 - ₹ 15,00,000 per year

Roles and Responsibilities:

  • 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 policy.
  • Interpret 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 difference between PA and an RI claim and verify the necessary details accordingly.
  • Verify the required documents for processing claims and raise an IR in case of an insufficiency.
  • Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of tariff.
  • Approve or deny the claims as per the terms and conditions within the TAT.
  • Handle escalations and responding to mails
  • accordingly.

Interested candidates can share their resumes to or Whatsapp on

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