hyderabad, telangana
INR Not disclosed
On-site
Full Time
As a Medical Doctor, you will be responsible for processing health claims in accordance with the standard operating procedures and guidelines provided. Your primary focus will be on achieving daily productivity targets while upholding quality standards. Your role will involve identifying potential fraud triggers and areas of possible leakage. It is essential for you to have a comprehensive understanding of health claims processing, staying updated on the latest regulations and their implications. Adherence to the specified turnaround times for each category is crucial. Your role will also require a solid foundation in medical knowledge and clinical efficacy of treatment protocols. You should possess the ability to analyze medication information in relation to the diagnosis, as well as a clear understanding of ICD and procedure codes. Case management skills will be necessary in situations where there is a risk of inflation or abuse. Additionally, you will need to interpret product wordings to make appropriate claims decisions.,
hyderabad, telangana
INR Not disclosed
On-site
Full Time
As a Medical Doctor, your main responsibility will involve the processing of health claims according to the standard operating procedures and guidelines provided. It is essential to achieve the expected productivity on a daily basis while maintaining high-quality standards. You will need to be vigilant in identifying fraud triggers and possible leakages to prevent any misuse. Having a thorough understanding of health claims processing is crucial for this role. It is important to stay updated with the latest regulations and their implications to ensure compliance. Adherence to the prescribed turnaround times for each category is necessary to meet the service level agreements. Your role will require comprehensive medical knowledge and proficiency in clinical treatment protocols. You should be capable of interpreting and analyzing information related to medications in correlation with the diagnosis. A clear understanding of ICD codes and procedure codes is essential for accurate claims processing. In situations where there is a potential for inflation or abuse, you will be responsible for case management to address such issues effectively. Additionally, being able to interpret product wordings to make appropriate claims decisions is a key aspect of this role.,
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