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Medical Officer @ Medi Assist

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 Medical Officer

Job Description

BAMS, BHMS, B Sc. Nursing MBBS (India Reg Mandatory)
 
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.
 
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)
Behavioral competencies:
  • Analytical Skills
  • Basic Computer knowledge
  • Type writing skills
  • Communication skills
  • Decision Making

Job Classification

Industry: Medical Services / Hospital
Functional Area / Department: Healthcare & Life Sciences
Role Category: Doctor
Role: Chief Medical Officer
Employement Type: Full time

Contact Details:

Company: Medi Assist
Location(s): Noida, Gurugram

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Keyskills:   opd bac emergency medicine dentistry diagnosis ayurveda nursing medicine hospital administration patient care general medicine healthcare claims processing claims surgical physician activities casualty doctor activities communication skills

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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...