We are looking for Medical Doctors to join our team for insurance claim assessment and medical scrutiny.
- Key ResponsibilitiesReview and medically assess health insurance claims.
- Scrutinize hospital records, IPD papers, discharge summaries, lab reports and treatment details.
- Assess medical necessity and appropriateness of hospitalization.
- Identify PED/NDC, discrepancies and suspicious claim patterns.
- Prepare medical opinions and investigation conclusions.
- Coordinate with hospitals, field investigators, insurance companies and TPAs.
- Review cashless and reimbursement claims.
- EligibilityMBBS / BHMS / BAMS / BDS / BPT or relevant medical qualification.
- Experience in Insurance / TPA / Claims / Medical Scrutiny will be preferred more.
- Good clinical knowledge and documentation skills.
- Freshers with good medical knowledge may also apply.
? Salary: Competitive, based on qualification & experience.
? Interested candidates can send their updated CV to us.
Build your career in the rapid-growing Health Insurance & TPA industry!