Medical Desk Auditor

The Medical Desk Auditor position at Phoenix Assurance Pvt Ltd requires a BHMS/BAMS graduate with a minimum of 3 years of clinical experience, particularly in TPA. The company, known for its expertise in claim verification and investigation, is a preferred partner for private insurance companies in various parts of India. The job location is in Gandhinagar, Gujarat, with the interview location at 1005 - 1006 10th Floor Shilp Zaveri Building, Ahmedabad, Gujarat 380015. The working hours are from 9:30 AM to 6:00 PM, Monday to Saturday. The ideal candidate should be well-versed in medical terminology, disease classification, and have a good understanding of the line of treatment. Knowledge of the STG set by NHA for processing claims of PMJAY is essential. Additionally, the candidate must have at least one year of experience in processing PMJAY claims or audits at the TPA/insurance company level. Basic computer skills including MS Office and email communication are required. Key responsibilities include conducting audits of pre-authorization claims and identifying any discrepancies, as well as auditing claims at or after the CPD level. The candidate will also be responsible for establishing standard processing guidelines and ensuring the processing team follows them accurately to reduce the company's loss ratio ethically. The position offers one week off and one paid leave per month. Immediate joining is required. For further information or to apply, interested candidates can send their CVs to hradmin@phoenixassurance.in or contact the HR Team at 63588-67434.,