MBBS Doctor

Role Overview: As a Medical Desk Auditor at Phoenix Assurance Pvt Ltd, you will play a crucial role in verifying and investigating claims for private insurance companies across India. Your responsibilities will include proficiency in medical terminology, disease classification, understanding of line of treatment, and knowledge of STG laid down by NHA for processing claims of PMJAY. You will also be required to have a minimum of 1 year of experience in PMJAY claim processing and/or audit at TPA/insurance company level. Basic knowledge of computer, MS Office, and mail communication is essential for this role. You will conduct audits of pre-authorization claims to identify any leakages, audit claims at or after CPD level to identify any leakages, establish standard processing guidelines, and guide the processing team for accurate claims processing. Additionally, you will perform activities to help reduce the loss ratio in an ethical manner. Key Responsibilities: - Proficiency in medical terminology, disease classification, understanding of line of treatment, and knowledge of STG laid down by NHA for processing claims of PMJAY. - Minimum 1 year of experience in PMJAY claim processing and/or audit at TPA/insurance company level. - Basic knowledge of computer, MS Office, and mail communication. - Conduct audits of pre-authorization claims to identify any leakages. - Audit claims at or after CPD level to identify any leakages. - Establish standard processing guidelines and guide the processing team for accurate claims processing. - Perform activities to help reduce the loss ratio in an ethical manner. Qualifications Required: - MBBS with GMC Certificate (FMCG candidates can also apply). (Note: The company, Phoenix Assurance Pvt Ltd, is a preferred partner for many private insurance companies in India for claim verification and investigation services.) If you meet the eligibility criteria and are interested in this position, you can send your CV to hradmin@phoenixassurance.in. Joining is immediate, and the job timings are from 9:30 AM to 6:00 PM, Monday to Saturday. Freshers are welcome to apply as well. The salary for this role ranges from 40,000 to 45,000, depending on the interview. You will have one week off and one paid leave per month. For any queries, you can contact Darshan Panchal at 63588-67434.,