Medical Officer

Vidal Health TPA is hiring for Medical officers fresher who have pursued BHMS/BAMS

Experienced candidates can apply as well.

Minimum qualification: Undergraduate in BHMS/BAMS

Designation: Medical Officer

Position Description:

The team of medical practitioner part of Pre-Authorization/Claims team will use their skills and expertise in authorizing the request received and they will ensure that the customers are attended on time by following the protocol of the policy defined by the insurer and the organization.

Roles and responsibilities:

• Dealing with patients health care related documents.
• Ensuring error free processing of preauthorisation within agreed TAT (Turnaround time).
• 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.
• 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.

Skills and Competencies:

• Medical practitioner/BHMS/BAMS or equivalent qualification
• 1-5 year experience in Pre-Authorization and Claims management.
• Sound medical knowledge and willing to work in non-clinic process.
• Experience in handling authorization is a add on.
• Should be willing to work in shifts as the department works on 24/7 function

No.of working days: 6

Training will be provided to fresher.

CTC: Up to 350,000 LPA

Location: Whitefield, Bangalore(Satya Sai Metro Station)

Mode: Work from office.