Insurance Medical Officer jobs in Bengaluru, Karnataka
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- Medi AssistBengaluru, Karnataka
- 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…
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- Vital Healthcare ServicesBangalore City, Bengaluru, Karnataka
- Review structured clinical data matching it against specified medical terms and diagnoses or.
- Sound medical knowledge and willing to work in non-clinic…
View similar jobs with this employerMEDI ASSIST INSURANCE TPA PRIVATE LIMITEDBengaluru, Karnataka- To approve Claims based on the buckets allotted to each approver.
- To inform the Network department in case of any erroneous billing / excess billing.
- Medi Assist Insurance TPA Private LimitedBengaluru, Karnataka
- Handle day-to-day cashless claim-related activities efficiently.
- Verify and validate information submitted by insured members.
- Medi Assist Insurance TPA Private LimitedBengaluru, Karnataka
- Handle day-to-day cashless claim-related activities efficiently.
- Verify and validate information submitted by insured members.
- Cytecare HospitalYelahanka, Bengaluru, Karnataka
- Coordinate with all nursing/Para medical & non medical staff of the department to maintain high standard of medical care to the patients.
- Mongoose Minds Private LimitedDoddakallasandra, Bengaluru, Karnataka
- Ability to identify bill inflations and discrepancies in insurance billing.
- Strong knowledge of surgeries, advanced medical treatments and procedure cost…
Job details
Pay information not provided
Bengaluru, Karnataka
Full job description
Bangalore/ Mumbai/ Noida
0 – 3 years
BAMS, BHMS, B Sc. Nursing & MBBS (India Reg Mandatory)
Apply now or send your resume to talent@mediassist.in
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)
Technical Competencies & Behavioral competencies:
- Analytical Skills
- Basic Computer knowledge
- Type writing skills
- Communication skills
- Decision Making
Apply now or send your resume to talent@mediassist.in
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