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Medical Officer/Sr. Medical Officer Hyderabad,Hyderabad (Job in Hyderabad Secunderabad)

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To apply for this job Click here IndiaMedJobs.com


 •    Pre-Authorization of Cashless and reimbursement request & Claims scrutiny or reviewing claims files in light of policy T & C of various insurance companies.



 •  Interaction with Health Care Providers & Coordination with internal - external teams in processing the cases .



 •  Medical scrutinizing, assessing and admissibility of medical claims, (Indian Subsidiary of WAPMED-Kuwait, Dubai, Abudabhi).



 •  E-Claims (Electronic Claims ) - these claims are receiving from Dubai and Abu Dhabi & Medical scrutinizing of these claims which comes in ICD-9 and ICD-10 format & CPT Codes Standardized by DHA, HAAD & following the guidelines pertaining to Insurance Companies of Middle East like  Al Ain Ahlia Insurance Company, INTERGLOBAL, AETNA, WARBA, RITAJ, Takaful Emarat Insurance etc.



 •  Paper / Physical Claims – from Kuwait – which comes in PDF format & Process claims as per healthcare guidelines by maintaining daily productivity.



 •  Well versed in proceeding of reimbursement claims of DHA HAAD & Indian Insurance claims.



 •  Commercial audit, Medical audit of claims and raising IR (information required) & issuing for PR (payment request).



 •  Generating claim IDs for data processing & thorough knowledge regarding claims validation & in final audit.



 •  Knowledge of policy concepts like Deductible, Coinsurance, Co-pay, and following plan guides for referring Policy benefit Exclusions in processing of claims.



 •  Continuous Quality improvement in Health Claims Processes & Maintaining TAT (Turn Around Time) for claims settlement.

To apply for this job Click here http://spanjobs.com/india/jobs/82292941 »



Posted on: Wednesday, 11 January, 2017  08:43
Expires On: Tuesday, 03 April, 2018  18:30

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