Consultant Medical Officer (Non-Clinical) - Mumbai

Roles & Responsibilities:

• Claim Processing: Verify the medical admissibility of a claim by confirming diagnosis and treatment details.
• Claim Scrutiny: Scrutinize claims according to the terms and conditions of the insurance policy.
• Data Interpretation: Interpret ICD coding, evaluate co-pay details, and classify non-medical expenses, room tariffs, and capping details. Differentiate between open billing and package deals.
• Process Verification: Understand the process difference between a PA and an RI claim, and verify necessary details accordingly.
• Document Verification: Verify all required documents for processing claims and raise an IR (Information Request) if documents are insufficient.
• Team Coordination: Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of a tariff.
• Claim Approval: Approve or deny claims as per the terms and conditions within the TAT (Turnaround Time).
• Communication: Handle escalations and respond to emails promptly.

Interested candidates can share their resumes via email or WhatsApp:

• Email: abhilasha.dutta@mediassist.in
• WhatsApp: 8050700698

Job Type: Full-time

Pay: ₹335,000.00 - ₹430,000.00 per year

Benefits:

• Health insurance
• Paid sick time
• Paid time off
• Provident Fund

Application Question(s):

• What is your current CTC?
• How many years of experience do you have?
• What is your expected CTC?

Work Location: In person