Medical Officer

Hi,

We are Vitraya Technologies Private Limited, an IT product-based company specializing in delivering innovative software solutions to the insurance industry. Given our focus on the insurance sector, we require professionals with a medical background or a strong understanding of medical terminology and procedures.

We invite individuals who have completed medical-related courses such as Nursing BDS, MDS,FDS or an Insurance TPA Background, MBBS and are looking to transition from a clinical setting to a corporate environment.

Role Overview: As part of the team, your primary responsibility will be to authenticate and validate medical documents submitted by hospitals and insurance companies. This includes:

-Ability to analyze medical records, discharge summaries, investigation reports, and correlate with diagnosis & procedures.

-Familiarity with clinical guidelines (NABH/WHO/ICMR) to judge medical necessity and appropriateness.

-Understanding of non-payable items, exclusions, and standard insurance T&Cs.

-Proficiency in reviewing tariff structures, SOC (Schedule of Charges), and billing accuracy.

-Experience in differentiating OPD vs IPD care and day-care vs long-stay admissions.

-Knowledge of fraudulent practices like upcoding, overcharging, and unnecessary procedures.

-Ability to map procedures and diagnoses with ICD-10 / ICD-11 and PCS coding standards.

-Awareness of claim processing workflows (Pre-auth, Enhancement, Final Claim settlement).

-Strong skills in decision documentation – providing clear, evidence-based justifications for approvals/rejections.

-Familiarity with health schemes and TPAs (private insurers, AB-PMJAY, state schemes).

-Good computer proficiency – MS Excel, claim portals, and automated adjudication systems.

-Attention to detail with ability to identify discrepancies in claims quickly.

-Strong communication skills to interact with hospitals, insurers, and internal teams.

-Team-oriented mindset with ability to work under tight TAT (Turn Around Time).

-Knowledge of medical abbreviations, short forms, and common documentation practices used in hospital bills.

Your role will be crucial in ensuring the integrity and accuracy of medical claims, contributing to a streamlined and efficient claims process for our clients.

Job Type: Full-time

Benefits:

• Food provided
• Health insurance
• Provident Fund

Work Location: In person

Interested Candidates can apply at anup.dobriyal@vitraya.com or WhatsApp their resume at9999043348. Kindly mention “Applying for Medical Officer” while applying on email or sending it to WhatsApp along with your CV attached.

Job Type: Full-time

Pay: ₹50,000.00 - ₹70,000.00 per month

Benefits:

• Food provided
• Health insurance
• Provident Fund

Education:

• Doctorate (Required)

Work Location: In person