DIDigit Insurance
Medical Doctor
Bangalore ₹1-5 LPA Posted 19 May 2025
FULL TIME
Regulatory Compliance
Fraud Detection
Case Management
Claims Processing
Icd Coding
Job Description
- Processing of health claims as per SOP/guidelines shared,
- Day to day achievement of expected productivity with out compromising on the quality parameters.
- Identification of Fraud triggers and possible leakage
- Complete understanding of health claims processing
- Aware of latest regulations and its implications
- Adherence to the prescribed TATs for each category
- Thorough medical knowledge, clinical efficacy of the treatment protocols given
- Able to read, interpret and question the information on the medication and relation to the diagnosis
- Clear understanding on ICD code and procedure codes
- Case management where there is possibility of inflation/abuse
- Interpretation of the product wordings for appropriate claims decisio