Qureos Mentor

CONNECT AND HEAL PRIMARY CARE PRIVATE LIMITED

About the companyConnect and Heal is a Bengaluru-based health-tech company that provides end-to-end coordinated care for employees. Founded in November 2016, CNH aims to be the first Health Maintenance Organization in India.Organisation: Connect and Heal Primary Care Private LimitedJob Title: NursePosition Overview:We are seeking a dedicated and compassionate Nurse to provide medical care to our corporate clients. In this role, you will be responsible for patient care, medicine inventory, and equipment audits, ensuring a high standard of healthcare services.Job Details:<ul><li>Level: Staff Nurse</li><li>Salary: &#8377;25,000 &ndash; &#8377;28,000 per month</li><li>No. of Vacancies: 3</li><li>Employment Type: Full-time, On-site</li><li>Working Days: 6 days a week</li><li>Working Hours: 8 AM &ndash; 5 PM</li></ul>Key Responsibilities:&#10004; Maintain and update patient records. &#10004; Dispense medications as per prescription. &#10004; Manage medicine inventory and ensure stock availability. &#10004; Conduct equipment audits and ensure all medical equipment is functional. &#10004; Provide first aid and immediate medical assistance when required.Requirements:&#9989; Education: B.Sc. Nursing or GNM (General Nursing and Midwifery) &#9989; Experience: Prior experience in hospitals, clinics, or healthcare centers with a strong commitment to patient care. &#9989; Skills: Basic communication skills in English, Hindi, and regional languages.Preferred Qualifications:B.Sc. Nursing or GNM with prior clinical experience.Benefits:&#10004; Competitive salary package &#10004; Continuous professional development and training opportunities &#10004; Collaborative and supportive work environmentJoin us in revolutionizing healthcare delivery through innovative telemedicine and corporate healthcare solutions! If you are passionate about patient care, we encourage you to apply and become a part of our dynamic team.Job Type: Full-timePay: &#8377;25,000.00 - &#8377;28,000.00 per monthWork Location: In person

Staff Nurse

Job Title: Occupational Health Center (OHC) DoctorLocation: On-SiteQualifications:<ul><li>MBBS (minimum requirement)</li></ul>Experience:<ul><li>Minimum 6 years of experience in managing OPD at Occupational Health Center (OHC) clinics.</li></ul>Language Proficiency:<ul><li>English and Hindi (mandatory)</li><li>Proficiency in local languages is an added advantage</li></ul>Job Description:<ul><li>Manage On-Site OHC OPD: Provide medical consultation, diagnosis, and treatment for employees in the on-site OHC clinic.</li><li>Clinic Management: Oversee day-to-day operations, ensuring smooth functioning and efficient patient flow.</li><li>Supervision and Compliance: Supervise the entire OHC facility and ensure compliance with NMC (National Medical Commission) guidelines, Factories Act standards, and current best practices.</li><li>Health Campaigns and Drives: Actively participate in vaccination drives and routine health check-up campaigns for employees.</li><li>EMR and Computer Proficiency: Comfortable using Electronic Medical Record (EMR) systems for patient management and documentation.</li><li>Continuous Learning: Stay updated with the latest medical knowledge, treatment guidelines, and industry standards.</li></ul>Skills and Competencies:<ul><li>Strong clinical knowledge and experience in Occupational Health.</li><li>Excellent communication and interpersonal skills.</li><li>Ability to work in a team-oriented environment.</li><li>Proficiency in using computer systems and EMR-based patient management.</li><li>Leadership abilities to supervise and ensure regulatory compliance.</li></ul>Why Join CNH?<ul><li>Opportunity to work in a dynamic occupational health environment.</li><li>Contribute to employee health and well-being.</li><li>Exposure to diverse medical cases and latest health practices.</li></ul>If you meet the qualifications and are passionate about occupational health, apply now to be part of our dedicated healthcare team!Job Type: Full-timePay: &#8377;85,000.00 - &#8377;105,000.00 per month

Occupational Health Center (OHC) Doctor

About Connect and HealConnect and Heal Primary Care Pvt. Ltd. is a leading integrated healthcare services provider, committed to delivering accessible, high-quality, and technology-enabled primary care solutions. Our ecosystem brings together emergency response, telemedicine, outpatient services, corporate health, and wellness programs to improve patient outcomes and enhance organizational health.Role OverviewThe Adjudication Specialist will play a critical role in ensuring accurate, timely, and compliant processing of healthcare claims and cases. The role involves reviewing medical documentation, validating clinical necessity, and ensuring that claims are adjudicated as per policy, regulatory, and contractual guidelines. The individual will work closely with medical, operations, and compliance teams to uphold quality, transparency, and efficiency in the adjudication process.Key Responsibilities<ul><li>Review, validate, and process healthcare claims, ensuring adherence to company policy, provider contracts, and regulatory standards.</li><li>Assess medical records and clinical documentation to confirm eligibility, coverage, and appropriateness of services claimed.</li><li>Ensure accurate coding (ICD, CPT, HCPCS) and alignment with medical necessity criteria.</li><li>Identify discrepancies, incomplete information, or potential fraud/abuse cases, and escalate where required.</li><li>Collaborate with the medical review board, doctors, and operations teams to resolve adjudication queries.</li><li>Maintain turnaround time (TAT) and service-level agreements (SLAs) for claim processing.</li><li>Document adjudication decisions clearly and consistently in the system.</li><li>Support internal and external audits by providing data and clarifications.</li><li>Recommend process improvements to enhance efficiency, reduce errors, and strengthen compliance.</li></ul>Required Qualifications &amp; Skills<ul><li>Graduate degree in healthcare, life sciences, or related field (Nursing, Pharmacy, MBBS, BDS preferred).</li><li>2&ndash;5 years of experience in healthcare adjudication, medical review, or claims processing.</li><li>Strong knowledge of health insurance policies, medical coding systems (ICD, CPT, DRG, HCPCS), and adjudication guidelines.</li><li>Familiarity with healthcare regulations (IRDAI, NABH, HIPAA preferred).</li><li>Excellent analytical skills with attention to detail and accuracy.</li><li>Ability to interpret clinical documentation and medical terminology.</li><li>Strong communication and documentation skills.</li><li>Proficiency in MS Office and healthcare adjudication software.</li></ul>Key Competencies<ul><li>Integrity and compliance orientation.</li><li>Analytical and problem-solving ability.</li><li>High attention to detail with process discipline.</li><li>Ability to work under pressure and meet deadlines.</li><li>Collaboration and cross-functional communication.</li></ul>Job Types: Full-time, PermanentPay: &#8377;400,000.00 - &#8377;550,000.00 per yearBenefits:<ul><li>Health insurance</li><li>Provident Fund</li></ul>Work Location: In person

ADJUDICATOR

Join CONNECT AND HEAL PRIMARY CARE PRIVATE LIMITED and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

CONNECT AND HEAL PRIMARY CARE PRIVATE LIMITED

ABOUT_COMPANY

Staff Nurse

Occupational Health Center (OHC) Doctor

ADJUDICATOR