BAMS / BHMS - Non Clinical Role

Medi Assist; Sangamwadi; On-site; INR 450,000 - 650,000; Full time

Job summary

Medi Assist in Pune is seeking Medical Officers (Work From Office Only) to review and process health insurance claims using medical knowledge and policy guidelines. The position is based in Pune and requires 0–3 years of relevant experience, with a qualification of BAMS/HBMS or MBBS.

You will evaluate medical admissibility, scrutinize claim documents, and ensure timely and accurate claim decisions while maintaining high standards of accuracy and compliance with policy terms.

Qualifications

• Freshers or candidates with up to 3 years in healthcare, hospitals, insurance, or TPA may apply.
• Strong analytical and decision-making abilities are expected.
• Good communication and computer proficiency are required.

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.

Skills

Analytical thinking

Decision making

Communication skills

Computer proficiency

Education

BAMS/BHMS

MBBS

Job description

Medical Officer (Work From Office Only)

Location: Pune

Experience: 0 to 3 Years

Qualification: BAMS / BHMS OR MBBS

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.