Medical Officer
Vidal Health Tpa Private Limited · Ghar se kaam
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KahanGhar se kaamRanchi
TypeFulltime
Posted22 Sep25 din pehle, Indeed se
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Job Description – Medical Officer (MO)
- Position
- Medical Officer (MO)
- Department
- Medical / Claims Processing
- Location
- Ranchi, Jharkhand
- Number of Openings
- 5
- Employment Type
- Full-Time
- Experience
- 0–5+ Years
- Qualification
- BAMS / BHMS / BDS
- Registration
- Valid State/National Medical Council registration is mandatory
Key Responsibilities
- Review and assess medical claims and related patient/hospital documents.
- Verify diagnosis, treatment details, medical records, prescriptions, investigation reports, and bills.
- Evaluate the medical necessity and appropriateness of treatment as per applicable guidelines and policies.
- Scrutinize pre-authorization and reimbursement claims.
- Identify discrepancies, missing documents, inconsistencies, or potential fraud indicators in claims.
- Coordinate with hospitals and internal teams for clarification and additional medical documents.
- Provide medical opinions and recommendations on claim admissibility.
- Ensure timely processing of assigned claims while maintaining accuracy and quality.
- Maintain proper documentation and records of claim assessments.
- Follow company SOPs, medical guidelines, and applicable regulatory requirements.
- Support the team in meeting defined productivity, quality, and turnaround-time (TAT) targets.
- Pay
- ₹20,813.87 - ₹37,171.55 per month
- Work Location
- Remote
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