Job Description

Roles & Responsibilities:

Claim Processing:

Verify the medical admissibility of a claim by confirming diagnosis and treatment details.

Claim Scrutiny:

Scrutinize claims according to the terms and conditions of the insurance policy.

Data Interpretation:

Interpret ICD coding, evaluate co-pay details, and classify non-medical expenses, room tariffs, and capping details. Differentiate between open billing and package deals.

Process Verification:

Understand the process difference between a PA and an RI claim, and verify necessary details accordingly.

Document Verification:

Verify all required documents for processing claims and raise an IR (Information Request) if documents are insufficient.

Team Coordination:

Coordinate with the LCM team in case of higher billing and with the provider team in case of non-availability of a tariff.

Claim Approval:

Approve or deny claims as per the terms and conditions within the TAT (Turnaround Time).

Communication:

Handle escalations and respond to emails promptly.

Interested candidates can share their resumes via email or WhatsApp:

Email:

abhilasha.dutta@mediassist.in

WhatsApp:

8050700698
Job Type: Full-time

Pay: ₹335,000.00 - ₹430,000.00 per year

Benefits:

Health insurance Paid sick time Paid time off Provident Fund
Application Question(s):

What is your current CTC? How many years of experience do you have? What is your expected CTC?
Work Location: In person