Medical Officer - Mediclaim Process (MBBS/BAMS/BHMS ONLY)

Job Overview

This is a non-clinical position at a US-based multinational corporation located on-site in Vadodara, Gujarat. The primary responsibility is to meticulously assess patients' medical records in large volumes, conduct clinical evaluations based on defined methodologies, and produce detailed reports including chronologies, summaries, and medical opinions related to case validity and valuation.

Key Responsibilities

• Review and interpret extensive medical records relevant to pre- and post-settlement insurance projects.
• Analyze clinical data applying medical terminology and diagnostic understanding effectively.
• Comply strictly with company policies and uphold the organizational culture.
• Maintain adherence to the Health Insurance Portability and Accountability Act (HIPAA) at all times.
• Provide daily productivity and quality updates to the medical team lead.

Qualifications and Experience

• Degree in MBBS (freshers and experienced candidates are welcome), or BHMS/BAMS with a minimum of one year of claims process experience in the insurance sector (mandatory for BHMS/BAMS candidates).

Essential Skills

• Familiarity with basic healthcare data analysis and clinical review procedures.
• Strong understanding of medical terminology, clinical assessments, and patient evaluation.
• Proficiency with Microsoft Word, Adobe, and Excel software.

Preferred Skills

• Knowledge of HIPAA regulations.
• Critical thinking abilities.
• Basic awareness of US culture and organizational behavior.