Medical Coordinator Officer

Key Responsibilities: 1. Medical Records Review & Case Scrutiny:  o Evaluate and review medical records and cases to provide expert medical opinions for health insurance processes, including pre-authorizations and claims. 2. Medical Terminology Expertise:  o Apply a strong understanding of medical terminology in a non-clinical environment. 3. Policy & Protocol Adherence:  o Ensure thorough knowledge and compliance with health insurance policies, terms, and protocols related to claims adjudication and processing. 4. Standard Operating Procedures (SOPs):  o Implement and follow SOPs in all activities to ensure consistency and accuracy. 5. Procedure Coding:  o Accurately code treatments and procedures in line with medical guidelines. 6. Volume Management:  o Efficiently manage case volumes to meet turnaround time (TAT) requirements.