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 qualification
• 0-3 years' experience in Pre-Authorization and Claims management.
• Sound medical knowledge and willing to work in non-clinic process.
.• Minimum of one year experience in handling authorization (preferred)
• Should be willing to work in shifts and should be willing to work from office (no WFH)
• Prior & relevant experience in the Health Tech Industry would be an added advantage.Key Results
• Excellent Interpersonal Skills
• Exceptionally high motivation levels and needsto be a self-starter.• Solid analyticalskills
• Exceptionally High level of proficiency in MS Office (PowerPoint and E

📌 Medical Officer (Bengaluru)
🏢 Vidal Health
📍 Bengaluru