Bsc Nursing-Non Clinical – MEDI ASSIST INSURANCE TPA PRIVATE LIMITED – Full Job Description

Company: MEDI ASSIST INSURANCE TPA PRIVATE LIMITED
Location: Bengaluru, Karnataka
Job Type: Full-time
Salary: ₹2,70,000 – ₹3,30,000 a year

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Job Description: Medical Claims Analyst

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

Scrutinize the claims, as per the terms and conditions of the insurance policy.

• Interpret the ICD coding, evaluate co-pay details, classify non-medical expenses, room tariff, capping details, differentiation of open billing and package etc.
• Understand the process difference between PA (Pre-Authorization) and an RI (Reimbursement) claim and verify the necessary details accordingly.
• Verify the required documents for processing claims and raise an IR (Information Request) in case of an insufficiency.
• Coordinate with the LCM (Loss Control Management) team in case of higher billing and with the provider team in case of non availability of tariff.
• Approve or deny the claims as per the terms and conditions within the TAT (Turnaround Time).
• Handle escalations and responding to mails accordingly.

This is a WFO (Work From Office) role only.

Job Type: Full-time
Pay: ₹270,000.00 – ₹330,000.00 per year

Benefits:

• Health insurance
• Provident Fund

Schedule: Rotational shift

Application Question(s):
Current CTC
Expected CTC

License/Certification:
Bsc nursing (Required)

Work Location: In person

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