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: [email protected]
- WhatsApp: +91-XXXXXXXXXX

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

📌 BHMS, BAMS, B.Sc Nursing -Non Clinical (India)
🏢 MEDI ASSIST INSURANCE TPA PRIVATE
📍 India