Designation: Medical Officer
We are looking for Medical Officers to review and process health insurance claims by applying medical knowledge and policy guidelines. The role involves evaluating medical admissibility, scrutinizing claim documents, and ensuring timely and accurate claim decisions.
Roles and Responsibilities
- Assess medical claims and verify diagnosis, treatment details, and admissibility.
- Review claims as per insurance policy terms and conditions.
- Evaluate ICD coding, co-payments, non-medical expenses, room rent limits, and package charges.
- Verify supporting documents and raise requirements for incomplete cases.
- Coordinate with internal teams for claim-related clarifications and escalations.
- Approve or deny claims within defined turnaround times (TAT).
- Handle claim-related queries and email communications.
Required Knowledge /Skill : Clinical / TPA /Medical knowledge with insurance background
Education : BHMS/ BAMS/BSc Nursing
Working timing: General Shift - 8.5 hours
Job Location : Marol, Andheri East
Note : This position is for Working from office only. Please do not apply if you are looking for working from home.
Interested candidates may send their CV to [email protected] OR WhatsApp to 8050700698
Job Types: Permanent, Fresher
Pay: ₹20,000.00 - ₹28,000.00 per month
Application Question(s):
- Please confirm if you are ok for Marol, Mumbai location, working from office?
Work Location: In person
