Medical officer-Medical Officer-TPA Billing

Key Responsibilities

• Clinical Scrutiny: Analyze and approve/deny patient claims by verifying the diagnosis, treatment details, and medical necessity based on insurance policy terms.
• Billing & Coding: Interpret ICD coding, evaluate co-pay/deductibles, and manage the distinction between package and open billing.
• Authorization: Review and process pre-authorizations for cashless treatments.
• Documentation: Ensure all required documentation (discharge summaries, investigations) is complete to avoid claim rejection.
• Liaison: Coordinate with hospital departments (doctors, billing) and TPAs/insurance companies to resolve queries and reduce Turnaround Time (TAT). Docthub +5

Job Type: Full-time

Pay: ₹25,000.00 - ₹45,000.00 per month

Work Location: In person