Job description Location Raipur Chhattisgarh Experience 1 4 Years Employment Type FullTime Freelance Job Summary We are looking for enthusiastic Medical Officers to join our Cashless Claims team The role involves reviewing and processing cashless hospitalization requests evaluating medical records and ensuring timely authorization of claims in accordance with clinical guidelines and organizational policies This opportunity is ideal for BHMS BAMS BDS and BPT graduates who are looking to build a career in the healthcare insurance and TPA industry Eligibility BHMS BAMS BDS Bachelor of Physiotherapy BPT Experience 0 62 years of experience Candidates with exposure to hospitals TPAs health insurance or medical claims processing will be preferred Key Responsibilities Review and process cashless hospitalization requests received from network hospitals Analyze patient medical records diagnosis treatment plans investigation reports and discharge summaries Evaluate the medical necessity and appropriateness of the proposed treatment Authorize modify or recommend cashless claims as per clinical guidelines and policy terms Ensure accurate and timely processing of preauthorization and enhancement requests Coordinate with hospitals treating doctors and internal teams to obtain medical clarifications whenever required Maintain the prescribed turnaround time TAT and quality standards Document claim decisions accurately in the claims management system Escalate complex or exceptional cases to senior medical reviewers Ensure compliance with organizational regulatory and healthcare insurance guidelines Required Skills Strong knowledge of Anatomy Physiology Pathology Pharmacology and Medical Terminology Ability to interpret medical records and clinical documentation Good analytical and decisionmaking skills Excellent attention to detail Good communication and interpersonal skills Basic knowledge of MS Office and computer applications Ability to work in rotational shifts and a targetdriven environment Preferred Experience Cashless Claims Processing Health Insurance Third Party Administrator TPA Hospital Insurance Desk Medical Claims Adjudication Clinical Documentation Review Salary Benefits Market-competitive salary based on experience Performancebased incentives Career growth opportunities in the healthcare insurance domain Training and professional development Benefits Flexible schedule Health insurance Work from home Work Location Hybrid in Naya Raipur Raipur Chhattisgarh

📌 Medical Officer Claims Processor (Raipur)
🏢 Square Business Services
📍 Raipur