The team of medical practitioner part of Pre-Authorization team will use their skills and expertise in authorizing the request received and they will ensure that the customers are attended on time by following the protocol of the policy defined by the insurer and the organization.Ensuring error free processing of preauthorisation within agreed TAT (Turnaround time) by way of following the following process, o By entering accurate information into the application defined by the organization. o Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes and follow established procedures defined by the insurer and the organization. o Inform providers as needed and file completed precertification requests as per procedures o Interacting with providers for discharge summery etc.. as and when required. Medical practitioner/BDS/BHMS/BAMS or equivalent qualification Ensure 100% accuracy of all the authorization approval as per the process. Any authorization not as per the limit or as per the process to be escalated to the team manager on priority. 0-3 years experience in Pre-Authorization and Claims management. Any medical opinion required from the specialist to be escalated to the specialist. Sound medical knowledge and willing to work in non clinic process.Ensuring process compliance is met as per regulatory procedures. Minimum of one year experience in handling authorization (preferred)Maintaining Daily excel maintenance for Pre auth cases received and processed. Should be willing to work in shifts as the department works on 24/7 functionSolving customer queries wherever medical opinions are required and need to be address by the medical practitionerShould be willing to work from office (no WFH)Salary: 20-22K for freshers having no TPA experience

Greetings from Vidal Health Insurance TPA Pvt Ltd.,Openings For District Medical Officer!!! - Non Clinical RoleQualification -BDS / MBBS(FMG - Non MCI)Experience - 0 to 1 YearJob Location - Chennai Roles and Responsibilities Involved in analyzing medical reports and do medical Audit at the Hospitals.Should have medical knowledge.Providing quality services.Updating the new medical terms and conditions as per the policy.Should be good knowledge in Academics.Resolving Claims related queries and discrepancies, Following up and responding to queries of customers.Approving and Rejection of Payments to the Customers with all verification.Updating the Status of the Customers about the respective Claim/Preauth.Play as an intermediate role between the Insurance co., and the Customer.Handling Customer queries and giving a prompt reply to the customers through email.Preparing the Weekly consolidated reports of the team and updating to the Management.Assigning and Resolving Customer Queries through email.Raising Shortfall whenever it is necessary.Approving and Rejecting of Claim/Preauth after all necessary checks Interested Candidates can Whatsapp(no calls please ) your resume to Udaya Kumar R - 9940138034 or Apply in Naukri Itself. RegardsUdaya Kumar R9940138034

Position Description:The team of medical practitioner part of Pre-Authorization team will use their skills and expertise in authorizing the request received and they will ensure that the customers are attended on time by following the protocol of the policy defined by the insurer and the organization.Job Description:Ensuring error free processing of Pre-Authorization within agreed TAT (Turnaround time) by way of following the following process, o By entering accurate information into the application defined by the organization. o Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes and follow established procedures defined by the insurer and the organization. o Inform providers as needed and file completed precertification requests as per procedures o Interacting with providers for discharge summery etc.. as and when required. Skills and Competencies:Medical practitioner/BDS/BHMS/BAMS or equivalent qualification Ensure 100% accuracy of all the authorization approval as per the process.Any authorization not as per the limit or as per the process to be escalated to the team manager on priority. 0-3 years experience in Pre-Authorization and Claims management. Any medical opinion required from the specialist to be escalated to the specialist. Sound medical knowledge and willing to work in non clinic process.Ensuring process compliance is met as per regulatory procedures. Minimum of one year experience in handling authorization (preferred)Maintaining Daily excel maintenance for Pre auth cases received and processed. Should be willing to work in shifts as the department works on 24/7 functionSolving customer queries wherever medical opinions are required and need to be address by the medical practitionerShould be willing to work from office (no WFH)Role & responsibilities Contact:HR - Swathi S KumarMob No: 7760595011/89518 93649Email ID: swathi.kumar@vidalhealth.com

Role & responsibilities Claims Processing Preferred candidate profile B.PharmacyPerks and benefits

Job Title: ExecutiveLocation: Chennai T-NagarType: Full-Time Key Responsibilities:Manage CRM System: Oversee and customize the CRM software, ensuring data accuracy and system efficiency.Enhance Client Relationships: Develop strategies to boost client engagement and satisfaction.Analyze Data: Generate reports and insights to improve client interactions and service quality.Collaborate Across Teams: Work with Sales, Marketing, and Customer Service to align CRM efforts with business goals.Process Improvement: Identify and implement improvements in CRM processes.Qualifications:Experience: 1-3 years in CRM roles within the TPA industry.Skills: Proficiency in strong analytical and communication skills.Education: Bachelors degree in a relevant field; certifications are a plus.

Job Title: Medical Officer (Claim Processing)Location: Chennai T-NagarType: Full-Time Skills and Qualifications:Medical Knowledge: Strong understanding of medical terminology, treatments, and procedures.Analytical Skills: Ability to assess medical records and evaluate claims based on necessity and policy guidelines.Attention to Detail: High accuracy in reviewing claims and supporting documentation.Communication Skills: Effective in liaising with healthcare providers, patients, and colleagues.Regulatory Knowledge: Familiarity with healthcare regulations and billing codes.Problem-Solving: Ability to resolve claim disputes and issues efficiently.Technical Skills: Proficiency in claim processing software and medical management tools.Educational and Professional Requirements:Education: Medical degree (MBBS, MD, or equivalent).Experience: Experience in healthcare or insurance claims processing is preferred.