BAMS / BHMS - Non Clinical Role

Medi Assist; Mumbai; Sur place; INR 400 000 - 650 000; Plein temps

Résumé du poste

Medi Assist in Mumbai is seeking a Medical Officer (Work From Office Only) to review and process health insurance claims using medical knowledge and policy guidelines. The role involves evaluating medical admissibility, scrutinizing claim documents, and ensuring timely and accurate claim decisions.

Responsibilities include verifying diagnoses, reviewing ICD coding, and coordinating with internal teams to resolve claim inquiries within TAT.

Qualifications

• BAMS or BHMS with MBBS and Indian medical registration.
• 0–3 years of experience in healthcare, hospitals, or insurance.

Responsabilités

• Assess medical claims for admissibility and verify diagnosis and treatment details.
• Review claims per policy terms and conditions.
• Evaluate ICD coding, co-payments, room rent limits, and package charges.
• Verify supporting documents and raise requirements for incomplete cases.
• Coordinate with internal teams for clarifications and escalations.
• Approve or deny claims within defined turnaround times (TAT).
• Handle claim-related queries and emails.

Connaissances

Analytical ability

Decision making

Communication

Formation

MBBS with Indian registration

BAMS

BHMS

Outils

Computer proficiency

Description du poste

Medical Officer (Work From Office Only)

Location: Mumbai

Experience: 0 to 3 Years

Qualification: BAMS / BHMS and MBBS(With indian registration)

We are looking for Medical Officers to review and process health insurance claims by applying medical knowledge and policy guidelines. The role involves evaluating medical admissibility, scrutinizing claim documents, and ensuring timely and accurate claim decisions.

Key Responsibilities:

• Assess medical claims and verify diagnosis, treatment details, and admissibility.
• Review claims as per insurance policy terms and conditions.
• Evaluate ICD coding, co-payments, non-medical expenses, room rent limits, and package charges.
• Verify supporting documents and raise requirements for incomplete cases.
• Coordinate with internal teams for claim-related clarifications and escalations.
• Approve or deny claims within defined turnaround times (TAT).
• Handle claim-related queries and email communications.

Desired Candidate Profile:

• BAMS, BHMS
• Strong analytical and decision-making skills.
• Good communication and computer proficiency.
• Freshers and candidates with up to 3 years of experience in Healthcare, Hospitals, Insurance, or TPA industry may apply.