Medical Officer- Non clinical @ Medi Assist

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Medical Officer- Non clinical

Medi Assist
0 - 5 years
Pune
3 days ago
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Job Description

Job description

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, differentiate 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 respond to emails accordingly.

Interested candidates can share their CV'S to do********y@me*******t.in or WhatsApp to 9632777***

Job Classification

Industry: Insurance
Functional Area / Department: Customer Success, Service & Operations
Role Category: Operations
Role: Operations - Other
Employement Type: Full time

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Company: Medi Assist
Location(s): Pune

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Keyskills: TPA Experience Medical Knowledge BAMS Claims Adjudication Claims Processing BSC Nursing BHMS medical officer Msc Nursing

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₹ .25-4.25 Lacs P.A

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Your name (*)

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Current / Recent Company (*)

Experience (*)

Expected Salary (*)

Desired Industry (*):

Functional area / Department (*):

Enter Skills (key skills, subjects, technologies & roles to use in search)

Write briefly about yourself, your experience and education (*)

Attach ResumeMax 2.38 MB (RTF, PDF, DOC, DOCX formats only parsed)

Please, check the file size and type.

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Medi Assist

We are Indias leading HealthTech, and InsurTech 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. Explore mor...

Medical Officer- Non clinical @ Medi Assist

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