Company: Medi Assist TPA Health insurance

Location: Pune - Dhole patil road, Sangamvadi

Job Type: Full-time, Permanent

Shift: Fixed Day Shift (No night shifts / No rotational shifts)

Salary: ₹2,40,000 – ₹4,50,000 P.A. + Corporate Benefits

Job Overview

We are looking for enthusiastic and detail-oriented BAMS / BHMS Doctors to join our Medical Operations team. In this non-clinical corporate role, you will leverage your clinical knowledge to review hospitalization claims, assess medical necessity, verify policy coverage, and make decision calls on claim approvals and denials within stipulated turn-around times (TAT).

Key Responsibilities1. Medical Admissibility & Clinical Review

- Evaluate inpatient hospitalization claims by reviewing clinical notes, diagnostic reports, discharge summaries, and active line of treatment.
- Confirm accuracy of working diagnosis against prescribed treatment protocols, ICU stays,



surgical procedures, and duration of active management.
- Assess medical necessity and cross-check treatments against evidence-based clinical protocols.

2. Document Verification & Information Management

- Verify mandatory claim documents (hospital bills, indoor case papers, pharmacy bills, diagnostic reports, and authorization forms).
- Identify missing, insufficient, or ambiguous medical records and raise structured Information Requests (Queries) to network hospitals or insured policyholders.
- Re-evaluate query responses to determine claim eligibility.

Thanks

Hariprasad

Email - [email protected]

Mob : +91-XXXXXXXXXX

Pay: ₹30,000.00 - ₹35,000.00 per month

Perks:

- Provident Fund

Work Location: In person

📌 BAMS,BHMS & Bsc nursing -Pune (Non clinical)
🏢 Medi Assist India TPA
📍 Pune