Medical Officer- Non clinical
- Medi Assist
- 0 - 3 years
- Noida, Gurugram
- 6 months ago
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Job Description
About Us:
Medi Assist is India's leading Health Tech and Insure Tech company focused on
administering health benefits across employers, retail members, and public
health schemes. We consistently strive to drive innovation and participate in
such initiatives, to lower health care costs.
Our Health Benefits:
Administration model is designed to deliver the tools necessary for a health
plan to succeed, whether its our modular claims management system, our
technology that unveils data to make important decisions, or our service
solutions built around the voice of the customer. In short, our goal is to link
our success to that of our members
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.
Qualification:
BAMS
BHMS
Work from office only
Interested candidates can send their CV to va**********i@me*******t.in
Job Classification
Industry: InsuranceFunctional Area / Department: Healthcare & Life SciencesRole Category: DoctorRole: Medical OfficerEmployement Type: Full timeContact Details:
Company: Medi AssistLocation(s): Noida, Gurugram
Keyskills: TPA BHMS BAMS OPD Ayurveda Health Care Services Gynecology Doctor Activities General Medicine First Aid Homeopathy Medicine Patient Care Mediclaim Radiology Investigation Medical Hospital Emergency Diagnosis
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