01 Oct
|
Medi Assist
|
Bengaluru
01 Oct
Medi Assist
Bengaluru
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