Medical Officer

Family Health Plan (FHPL); Pune District; Presencial; INR 300 000 - 550 000; Tempo integral

Resumo da oferta

Family Health Plan (FHPL) is seeking a qualified professional in Pune District, Maharashtra, to manage end-to-end healthcare claims processing. The role requires reviewing medical records, bills and related documents to assess claim validity while coordinating with providers, insurers and patients to resolve issues.

The ideal candidate holds BAMS/BUMS/BHMS with registration, possesses 1–6 years of TPA experience, and demonstrates strong understanding of healthcare services and claims management

Qualificações

• 1-6 years of experience in TPA (Third Party Administrator).
• BAMS/BUMS/BHMS qualified doctors with registration required.
• Strong understanding of health care services, claims processing and claims management principles.
• Proficiency in handling multiple tasks simultaneously while maintaining attention to detail.

Responsabilidades

• Manage claims from receipt to settlement, ensuring timely and accurate processing.
• Conduct thorough analysis of medical records, bills, and other documents to determine claim validity.
• Coordinate with healthcare providers, insurance companies, and patients to resolve claim-related issues.
• Ensure compliance with regulatory requirements and industry standards for claims adjudication.
• Maintain accurate records of all interactions related to claims management.

Conhecimentos

Attention to detail

Multitasking

Claims processing

Formação académica

BAMS/BUMS/BHMS with registration

Descrição da oferta de emprego

Roles and Responsibilities

• Manage claims from receipt to settlement, ensuring timely and accurate processing.
• Conduct thorough analysis of medical records, bills, and other relevant documents to determine claim validity.
• Coordinate with healthcare providers, insurance companies, and patients to resolve claim-related issues.
• Ensure compliance with regulatory requirements and industry standards for claims adjudication.
• Maintain accurate records of all interactions related to claims management.

Desired Candidate Profile

• 1-6 years of experience in TPA (Third Party Administrator).
• BAMS/BUMS/BHMS qualified doctors with registration required.
• Strong understanding of health care services, claims processing, and claims management principles.
• Proficiency in handling multiple tasks simultaneously while maintaining attention to detail.