Medical Officer- Mumbai (Andheri)

• Scrutinize claim files and process the claims as per the terms and conditions of the insurance policy.
• Check the medical admissibility of a claim by confirming the diagnosis and treatment details.
• 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.
• Ensuring error free claim processing within agreed TAT (Turnaround time) by way of following process, by entering accurate information into the application defined by the organization.
• Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiate open billing and package, etc.
• Should have knowledge of processing reimbursement claims.
• Sound medical knowledge and willing to work in non clinic process.
• Ensuring process compliance is met as per regulatory procedures.

Job Location

Vidal Health Insurance TPA PVT LTD

513-522, 5th Floor B Wing, Chintamani Plaza,

Mohan Studio Compound,

Andheri Kurla Road, Mumbai-40009

Interested candidate can send updated resume on pratap.navane@vidalhealth.com or whatsapp me on 8652886133. or simply apply in Naukri.