Roles and Responsibilities
Involves Auditing of processed Claims / Preauth within timelines
Validating for process guidelines / Quality / other terms and conditions
Document observation and update in reports
Adjudicate Pre- Auth / Claims as assigned within a day with quality
Financial : To see to that there is no financial implication for the organization while settlement of claims
Role : Medical Officer
Required Knowledge /Skill : Positive Medical knowledge to evaluate the treatment plan
Education : BHMS / BAMS /BDS with valid registration number from any state
Shift timing: General Shift / Afternoon Shift / Evening Shift/ Night Shift