Medical Officers
Private Jobs posted 9 hours ago in Medical & Healthcare Shortlist Email JobJob Detail
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Job ID 500685
Job Description
Purpose of role:
To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge.
Medical Officers
Locations : Bangalore/ Mumbai/ Noida
Experience : 0 – 3 years
Education : BAMS, BHMS, B Sc. Nursing & MBBS (India Reg Mandatory)
Roles and Responsibility
- 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.
- Approve or deny the claims as per the terms and conditions within the TAT.
- Handle escalations and responding to mails accordingly
Key Results and Outcomes driven by this role:
- Error-free processing (100% Accuracy)
- Maintaining TAT
- Productivity (Achieve the daily targets)
Technical Competencies & Behavioral competencies:
- Analytical Skills
- Basic Computer knowledge
- Type writing skills
- Communication skills
- Decision Making
How to Apply
- The applications are invited online before 31st March 2026.
- Please update your profile from Dashboard and check eligibility.
- Click on APPLY to process online application.
