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Medi Assist
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Mbbs Doctor - Non Clinical Role

Mbbs Doctor - Non Clinical Role

Medi Assist

0 - 3 years

4 - 6 Lacs

noida

Posted:23 hours ago| Platform:

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Skills Required

tpa mediclaim claims claim settlement claims adjudication health insurance claims processing

Work Mode

Work from Office

Job Type

Full Time

Job Description

POSITION: MEDICAL OFFICER/CONSULTANT MOS APPROVER

Designation: Medical Officer/Consultant

Function: Claims MOS Approver

Reporting to: Assistant Manager Claims

Location: Noida

Educational Qualification: MBBS(Indian registration Required)

Shift: Rotational Shift (for female employee shift ends at 8:30 PM)

Week offs: 6 rotational week offs Provided per month

Management Level: Junior Management Level

Industry Type: Hospital/TPA/Healthcare/Insurance

Roles and Responsibilities

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.
Coordinate with the LCM team in case of higher billing and with the provider team in case of non- availability of tariff.
Approve or deny the claims as per the terms and conditions within the TAT.
Handle escalations and responding to mails accordingly.

Interested candidates please share your CV on:

Mail: abhilasha.dutta@gmail.com

Whatsapp: 8050700698

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