Key Objectives/Responsibilities of this Role:

- Ensuring error free processing of Pre Authorization within agreed TAT (Turnaround time) by way of following the following process, • By entering accurate information into the application defined by the organization.
- Review structured clinical data matching it against specified medical terms and diagnoses or procedure codes and follow established procedures defined by the insurer and the organization.
- Inform providers as needed and file completed precertification requests as per procedures o Interacting with providers for discharge summery etc.. as and when required.
- Ensure 100% accuracy of all the authorization approval as per the process.
- Any authorization not as per the limit or as per the process to be escalated to the team manager on priority.
- Any medical opinion required from the specialist to be escalated to the specialist.
- Ensuring process compliance is met as per regulatory procedures.
- Maintaining Daily excel maintenance for Pre auth cases received and processed.
- Solving customer queries wherever medical opinions are required and need to be address by the medical practitioner Preferred Skills/Tools:
- Medical practitioner/BDS/BHMS/BAMS or equivalent qua

📌 Medical Officer- TPA (Bengaluru)
🏢 Vidal Health Insurance
📍 Bengaluru