
Medical Claims Officer Position
1 day ago
We are seeking a skilled Medical Claims Officer to join our team. As a key member of our organization, you will be responsible for adjudicating medical cases, authorizing decisions, and performing comprehensive file reviews.
Main Responsibilities:
- Adjudicate medical cases within the stipulated turnaround time, ensuring high-quality standards in accordance with policy terms and conditions.
- Perform thorough file reviews, including multidisciplinary notes, lab reports, radiology reports, and other relevant documentation.
- Request necessary medical documentation or identify missing documents essential for decision-making.
Requirements:
- Bachelor's of Medicine (MBBS) with 1 year of clinical practice OR Bachelor of Nursing.
- 1-2 years of medical experience; experience with reputable insurance providers is advantageous.
- Knowledge of insurance industry practices and compliance with regulations.
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