Bangalore/ Mumbai/ Noida

0 – 3 years

BAMS, BHMS, B Sc. Nursing & MBBS (India Reg Mandatory)

Apply now or send your resume to [email protected]

Purpose of role:

To scrutinize and process the claims within the agreed TAT by having an understanding of the policy terms & conditions while applying their domain medical knowledge.

Roles and Responsibility

- Check the medical admissibility of a claim by confirming the diagnosis and treatment details.
- Scrutinize the claims, as per the terms and conditions of the insurance policy
- Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc.
- Understand the process difference between PA and an RI claim and verify the necessary details accordingly.




- Verify the required documents for processing claims and raise an IR in case of an insufficiency.
- Approve or deny the claims as per the terms and conditions within the TAT.
- Handle escalations and responding to mails accordingly

Key Results and Outcomes driven by this role:

- Error-free processing (100% Accuracy)
- Maintaining TAT
- Productivity (Achieve the daily targets)

Technical Competencies & Behavioral competencies:

- Analytical Skills
- Basic Computer knowledge
- Type writing skills
- Communication skills
- Decision Making

Apply now or send your resume to [email protected]

📌 Medical Officer (India)
🏢 Medi Assist
📍 India