Medical Officer,bhms jobs in Kerala
- Ocean GroupKaudiar, Kerala
- The Medical Officer will be responsible for medical assessment and adjudication of health insurance claims, pre-authorization requests, and medical queries.
- Cosmetiq HospitalPanampilly Nagar, Kochi, Kerala
- * MBBS degree with valid medical registration.
- * Handle emergencies and basic medical management when required.
- * Malayalam and English fluency preferred.
- Karunya HrudayalayaKottakkal, Kerala
- Bachelor's degree in Healthcare Management, Business Administration, Hospital Administration, or a related field.
- Proficiency in MS Office and digital tools.
- Tiruvalla Medical MissionKerala
- Good clinical and communication skills.
- Freshers and experienced candidates may apply.
- View all Tiruvalla Medical Mission jobs - Kerala jobs - Medical Officer jobs in Kerala
- Salary Search: RESIDENT MEDICAL OFFICER (RMO) salaries in Kerala
- MAGJ HOSPITALAngamally, Kochi, Kerala
- Ability to handle medical emergencies efficiently.
- Respond to all medical emergencies, including Code Blue situations.
- MBBS from a recognized Medical College.
- MES Medical CollegeMalappuram, KeralaHiring Resident Medical Officers for our reputed Medical College Hospital. Qualification: MBBS Experience: 0-5 years Interested candidates may apply with…
- Somatheeram Ayurvedic Hospital & Yoga CentreVizhinjam, Thiruvananthapuram, Kerala
- Assume Night Duty Medical Officer responsibilities when required, including during the absence or unavailability of the designated officer, to ensure…
- Somatheeram Ayurvedic Hospital & Yoga CentreVizhinjam, Thiruvananthapuram, Kerala
- Assume Night Duty Medical Officer responsibilities when required, including during the absence or unavailability of the designated officer, to ensure…
- Sanjeevanam Ayurveda HospitalKochi, Kerala
- Job Types: Full-time, Permanent.
- Total work: 1 year (Preferred).
- Dr.shenoy's CAREKochi, Keralakindly share resume to hr@rheumacare.com hr@drshenoycare.com Pay: ₹30,000.00 - ₹50,000.00 per month Work Location: In…
- MVR CANCER CENTRE AND RESEARCH INSTITUTECalicut, Kerala
- Ensures proper admission, discharge of patients with proper paper work.
- Plans patient care and makes patient assignments as per their nursing needs.
- RCMASSIST HEALTHCARE SOLUTIONS PRIVATE LIMITEDKochi, Kerala
- Ernakulam, Kerala: Reliably commute or planning to relocate before starting work (Required).
- Role:- To coordinate with the hospital medical team and insurance…
- SBM HOSPITALKarunagappalli, Kerala
- ₹3500 per 12-hour shift.
- MBBS qualification and higher qualifiactions.
- Our Family ClinicAlleppey, Kerala
- Provide emergency medical care when required.
- Basic knowledge of electronic medical records (EMR) systems.
- The Medical Officer is responsible for providing…
- View all Our Family Clinic jobs - Alleppey, Kerala jobs
- Salary Search: Medical Officer salaries in Alleppey, Kerala
- Amrita Institute of Medical SciencesKochi, KeralaBSC Physician Assistant needed for Amrita Hospital. Pay: ₹25,000.00 - ₹30,000.00 per month Work Location: In…
- Our Family ClinicEriyad, Thrissur, Kerala
- Diagnose and manage common medical conditions.
- Ability to handle medical emergencies independently.
- Monitor patient progress and maintain accurate medical…
People also searched:
Job Post Details
Job details
Pay
- ₹18,000 - ₹20,000 a month
Job type
- Contractual / Temporary
- Freelance
- Full-time
Location
Benefits
Pulled from the full job description
- Health insurance
Full job description
Full job description
The Medical Officer will be responsible for medical assessment and adjudication of health insurance claims, pre-authorization requests, and medical queries. The role involves applying clinical knowledge to ensure accurate decision-making, compliance with regulatory guidelines, and prevention of fraud, waste, and abuse in claims processing.
Key Responsibilities
Claims Review & Adjudication
Review and validate pre-authorization and reimbursement claims based on medical necessity, clinical appropriateness, and policy terms.
Assess diagnostic reports, prescriptions, discharge summaries, and medical records for accuracy and completeness.
Ensure claims decisions are aligned with IRDAI regulations and company policy.
Pre-Authorization & Approvals
Evaluate pre-authorization requests within agreed turnaround times.
Liaise with treating doctors/hospitals to seek additional clinical information when required.
Fraud & Abuse Prevention
Identify potential fraudulent or exaggerated claims by analyzing treatment patterns and discrepancies.
Support field investigation teams with medical opinion.
Compliance & Documentation
Maintain accurate, confidential, and complete documentation for all cases handled.
Ensure compliance with industry regulations, ethical standards, and company SOPs.
Qualifications & Skills
Education:BAMS/BDS/BHMS/BYMS/BSMS
Experience: 2–5 years of clinical practice; prior experience in health insurance, TPA, or claims management is an advantage.
Knowledge:
Good understanding of clinical procedures, hospital billing, and ICD coding.
Familiarity with IRDAI guidelines and medical insurance processes.
Skills:
Strong analytical and decision-making skills.
Excellent written and verbal communication.
Ability to work in a fast-paced, process-driven environment.
On site Job.
Job Types: Full-time, Freelance
Pay: ₹18,000.00 - ₹20,000.00 per month
Ability to commute/relocate:
- Thiruvananthapuram, Kerala: Reliably commute or planning to relocate before starting work (Preferred)
Experience:
- Claim investigation : 1 year (Preferred)
Work Location: In person