Medical Officer

Family Health Plan (FHPL); Bengaluru; Presencial; INR 450 000 - 650 000; Tempo integral

Resumo da oferta

Family Health Plan (FHPL) is seeking a role-based professional in Bengaluru to scrutinize claims, coordinate with CRM for corporate benefit plans, and guide investigators with triggers for CDRF and surveyor cases.

The candidate will work with CRM to resolve critical issues, ensure proper documentation, and take final decisions on claim status in a fast-paced environment.

Qualificações

• BAMS/BUMS/BHMS with registration and relevant experience in TPA preferred.

Responsabilidades

• Scrutinize the claims as per the checklist.
• Coordinate with CRM team to obtain benefit plans of corporate and document/follow.
• Correspond and communicate to the investigator by giving triggers to the investigation team regarding CDRF and surveyor cases.
• Coordinate with CRM team and help sorting out critical issues and settle priority claims.
• Have final authority to decide on the status of a claim.

Formação académica

BAMS/BUMS/BHMS with registration

Descrição da oferta de emprego

Role & responsibilities

• To scrutinize the claims as per the checklist.
• Co-ordinate with CRM team for obtaining benefit plans of corporate and ensure that the same is documented and followed.
• Correspond and communicate to the investigator by giving triggers to the investigation team regarding CDRF and surveyor cases.
• Coordinate with CRM team and help them in sorting out critical issues and in settlement of priority claims.
• Final authority to decide on the status of claim.

Preferred candidate profile

BAMS/BUMS/BHMS candidates with registration and relevant experience into TPA is preferred.