- 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. •
- Coordinate with the LCM team in case of higher billing and with the provider team in case of non- availability of tariff. •
- Approve or deny the claims as per the terms and conditions within the TAT. Role & responsibilities
Preferred candidate profile
📌 Medical Officer (Bengaluru)
🏢 Medi Assist
📍 Bengaluru
Reply to this offer
Impress this employer describing Your skills and abilities, fill out the form below and leave Your personal touch in the presentation letter.