Position: Medical Doctor – Case File Auditor
Experience: Freshers and Experienced Doctors can apply
Qualification: MBBS / BDS / BAMS / BHMS / Equivalent Medical Qualification
Location: BANGALORE -CHENNAI -HYDERABAD
Employment Type: Full-time / Part-time
Job Overview
We are looking for qualified medical professionals to conduct hospital case file auditing and medical claim verification. The role involves reviewing patient case files and medical records to assess the accuracy, completeness, medical necessity, and consistency of hospitalization and treatment.
Key Responsibilities
- Audit hospital case files, IPD records, discharge summaries, investigation reports, prescriptions, OT notes and treatment records.
- Review diagnosis, treatment provided, investigations and procedures from a medical perspective.
- Verify whether the documented treatment is medically appropriate for the reported diagnosis.
- Identify discrepancies, inconsistencies, missing documents and unusual medical/billing patterns.
- Review pre- and post-hospitalization records wherever available.
- Assess medical necessity of hospitalization, ICU admission, surgery and other procedures.
- Review laboratory, radiology and operative findings and correlate them with the diagnosis.
- Prepare clear and concise medical audit/claim verification reports.
- Coordinate with investigation and field teams when clarification is required.
- Maintain confidentiality of patient and insurance-related information.
Skills Required
- Good understanding of clinical case sheets and hospital documentation.
- Strong medical record interpretation and analytical skills.
- Ability to identify discrepancies and inconsistencies.
- Good written communication and report-writing skills.
- Basic knowledge of insurance/medical claim documentation will be an advantage.
- Freshers can apply; training will be provided to suitable candidates.
Pay: ₹20,000.00 - ₹38,500.00 per month
Benefits:
- Cell phone reimbursement
- Flexible schedule
Work Location: In person
