Posted:2 days ago| Platform: SimplyHired logo

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Skills Required

Work Mode

On-site

Job Type

Full Time

Job Description

Key responsibilities:

  • Medical Scrutiny: Analyze medical reports and records to validate diagnoses and treatments submitted in pre-authorization requests.
  • Claim Processing: Evaluate claims against policy terms, conditions, and guidelines, checking for co-pay details, room tariffs, and non-medical expenses.
  • Decision Making: Authorize or deny claims based on the medical admissibility and policy rules.
  • Communication: Liaise with hospitals, insurance companies, and other stakeholders to resolve discrepancies and gather necessary information.
  • Documentation: Maintain accurate and detailed records of all claim interactions.
  • Compliance: Ensure all actions comply with insurance regulations and company policies.
  • Query Resolution: Handle and respond to queries and escalations from various parties.

Experience- 1+ year

Qualification- A medical degree such as BAMS, or BHMS is typically required.

Interested Candidates shared your CV on:
[email protected]

Job Type: Full-time

Pay: ₹25,000.00 - ₹55,000.00 per month

Benefits:

  • Health insurance
  • Provident Fund

Work Location: In person

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