Medical Officer/Sr. Medical Officer

Family Health Plan (FHPL)

0 - 2 years

3 - 4 Lacs

Chennai Bengaluru Mumbai (All Areas)

Posted:5 days ago| Platform:

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Skills Required

medical Insurance Claims Claims Adjudication Claims Processing Health Claims tpa cashless Adjudication health Cashless processing

Work Mode

Work from Office

Job Type

Full Time

Job Description

The candidate must have completed BHMS, BAMS, or BUMS from a reputed university."

Experience : 0 to 2 years

Locations : Bangalore, Chennai and Mumbai / Pune

Role & responsibilities

To give Claims & Cashless/preauthorization, and scrutiny Medical Reimbursement Claims, and to Process Claims
Third Party Administration (Health) services (TPA)
Claims and Preauthorization Processing
HealthCare Assistance Services
High Ratio Claims Management in coordination with Networking and Empanelment Department
Monitoring the overall operations of Claims and Preauthorization.
Responsible for ensuring efficient response at the level of Preauthorization to maintain TAT.
Ensure adherence to processes and controls.
Creating the process for claim processing (Cashless and Reimbursement).
Co-ordination between Network Hospitals/Preauthorization/Claims.
Ensuring a high-quality patient care at customized/optimized cost.
Creating the process for claim processing (Cashless and Reimbursement).

Preferred candidate profile

• Good Excellent oral and written communication, negotiation, and decision-making skills.
• Good customer service/relationship skills and ability to work effectively in a fast-paced environment with shifting priorities .

Must be willing to work in non - clinic

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