(Only 24h Left) Consultant - Medical Officer

Greeting from Medi assist TPA Pvt ltd.

Hiring Medical officer for Insurance Claim processing Profile

Location- Mumbai -Andheri East.

Role - Medical officer Exp : 0-3 years

WORK FROM OFFICE ONLY.

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, 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 nonavailability of tariff.
• Approve or deny the claims as per the terms and conditions within the TAT.

We are looking for fresher or exp candidates BAMS, BHMS, B.Sc Nursing, BPT, MBBS (ONLY Indian Registration)

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