Medical Coordinator (MCO)- Non clinical

• Scrutiny of medical records and cases; provide medical opinions for health insurance pre-authorization and claims.
• Process cashless requests and health insurance claim documents.
• Possess good knowledge of medical terminology and willingness to work in a non-clinical field.
• Understand health insurance policies, terms & conditions, protocols, and claims adjudication/processing.
• Follow and implement standard operating procedures (SOPs) and protocols.
• Perform treatment-wise procedure coding.
• Manage case volumes efficiently to maintain turnaround time (TAT).
• Be flexible to work in morning and afternoon shifts.
• Scrutinize medical records, cases and claim-related documents.
• Provide medical opinions/support for health insurance pre-authorization and claims.
• Process cashless requests and health insurance claim documents.
• Review medical terminology, policies, protocols and claim procedures.
• Good medical knowledge and understanding of medical terminology.
• Knowledge of health insurance, claims or pre-authorization is an advantage.
• Good oral and written communication skills.
• Strong coordination and decision-making skills.

Attention to detail.

• Ability to work in a fast-paced environment.
• Basic computer/MS Office knowledge.