Company Description Md India Health Care Services Private Limited is a consumer healthcare services company based in Pune, Maharashtra, India. The organization operates from Amritha Villa in the Kondwa Dhawade area, serving clients across the Pune division and surrounding regions. It focuses on providing health-related services and support to individuals and organizations, contributing to better access to care and healthcare administration.

Potential team members can expect to join a company that works closely with local communities and healthcare stakeholders to deliver reliable and compliant services.

Role Description The Medical Reviewer role is a full-time, on-site position located in the Pune Division.

The Medical

Reviewer is responsible for assessing medical documents, clinical records, and insurance-related files for accuracy, completeness, and compliance with relevant guidelines and policies. Day-to-day activities include reviewing patient case histories, validating diagnoses and treatments, verifying adherence to clinical protocols, and preparing explicit, concise review reports. The role also involves coordinating with healthcare providers, internal teams, and external stakeholders to clarify medical information, resolve discrepancies, and support fair and timely decisions on medical claims or services.

The Medical

Reviewer is expected to maintain strict confidentiality, follow regulatory standards,



and contribute to continuous improvement of review processes and quality benchmarks.

Qualifications

- Sound knowledge of clinical terminology, common medical procedures, and diagnostic practices, with the ability to interpret and evaluate medical records accurately.
- Experience in medical claims review, utilization review, or clinical audit within healthcare, insurance, third-party administration, or hospital settings.
- Strong analytical and critical thinking abilities for assessing the appropriateness of treatments, investigations, and medical documentation against established guidelines.
- Excellent written and verbal communication skills to prepare clear reports, document findings, and interact professionally with healthcare providers and internal teams.
- High attention to detail, integrity in handling sensitive health information, and commitment to maintaining confidentiality and regulatory compliance.
- Ability to work on-site in the Pune Division, manage time effectively, and handle multiple case reviews within defined timelines and quality standards.
- Proficiency in using basic office software and medical record systems; familiarity with health insurance processes or TPA workflows is an advantage.
- Relevant clinical qualification such as MBBS, BAMS, BHMS, BDS, or a nursing/paramedical degree; prior experience in medical review or clinical practice is preferred.

📌 Medical Reviewer (Pune)
🏢 Md India Health Care Services Private
📍 Pune