Insurance Medical Officer jobs in Bengaluru Urban District, Karnataka

Position: Medical Officer

Company: VHC

Department: Claims/Pre Auth

Location: WhiteField, Bangalore

CTC: 3.4 LPA To 7LPA

Company Overview:

Vidal Health is 100% Subsidiary of Bajaj Finserv Health (BFHL). Vidal Health was established in March

2002 with the mission to provide top quality TPA services to Health Insurance policyholders and be

the most preferred TPA in India. We are licensed by IRDA (Insurance Regulatory & Development

Authority - License No. 016) and have been empaneled by leading insurance companies, both public

sector and private, across different regions of the country. Vidal Health operates through four key

business verticals: Commercial, Government, International, and Self-Fund, with a presence both

across India and internationally.

Company Link: https://www.vidalhealthtpa.com/vidalhealthtpa

LinkedIn : https://www.linkedin.com/company/vidal-health/

Key Objectives/Responsibilities of this Role:

 Ensuring error free processing of Pre Authorization within agreed TAT (Turnaround time) by way of

following the following process,

 By entering accurate information into the application defined by the organization.

 Review structured clinical data matching it against specified medical terms and diagnoses or

procedure codes and follow established procedures defined by the insurer and the organization.

 Inform providers as needed and file completed precertification requests as per procedures o

Interacting with providers for discharge summery etc.. as and when required.

 Ensure 100% accuracy of all the authorization approval as per the process.

 Any authorization not as per the limit or as per the process to be escalated to the team manager on

priority.

 Any medical opinion required from the specialist to be escalated to the specialist.

 Ensuring process compliance is met as per regulatory procedures.

 Maintaining Daily excel maintenance for Pre auth cases received and processed.

 Solving customer queries wherever medical opinions are required and need to be address by the

medical practitioner

Preferred Skills/Tools:

• Medical practitioner MBBS or equivalent qualification
• 0-3 years' experience in Pre-Authorization and Claims management.
• Sound medical knowledge and willing to work in non-clinic process.
• Minimum of one year experience in handling authorization (preferred)
• Should be willing to work in shifts/ Roasters and should be willing to work from office (no WFH) and Sat & Sunday working.
• Prior & relevant experience in the Health Tech Industry would be an added advantage.

Key Results

• Excellent Interpersonal Skills
• Exceptionally high motivation levels and needs to be a self-starter.
• Strong analytical skills
• Exceptionally High level of proficiency in MS Office (PowerPoint and Excel)

Pay: ₹300,000.00 - ₹800,000.00 per year

Benefits:

• Paid sick time
• Paid time off
• Provident Fund

Ability to commute/relocate:

• Bangalore City, Bengaluru, Karnataka: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Are you willing to do work on Saturday and Sunday?
• Are you comfortable working in Night Shifts?
• Are you willing to work in different shifts?

Education:

• Bachelor's (Required)

Experience:

• TPA: 1 year (Required)

Work Location: In person