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Medical Evaluation Specialist
Dinoxo
Bengaluru / Bangalore
Not Disclosed
5 - 10 Years
Full Time - Permanent
Views:7
Applicants:0
Posted on 29 Jul, 2026
In Office
Job Description | Responsibilities
- Review and evaluate health insurance claims using medical records, clinical protocols, and policy guidelines.
- Prepare evidence-based medical justifications and support claim appeals and reconsiderations.
- Analyze medical documentation, identify assessment errors, and prepare detailed review reports.
- Coordinate with insurance companies, TPAs, hospitals, and physicians for claim resolution.
- Ensure compliance with healthcare regulations, insurance policies, and quality standards.
Overview
- Industry - MEDICAL / HEALTHCARE / HOSPITALS
- Job Role - Medical Evaluation Specialist, Medical Officer, Medical Auditor, Medical Consultant
- Employment type - Full Time - Permanent
- Work Mode - In Office
Qualifications
- Any Graduate - Any Specialization
- Any Post Graduate - Any Specialization
- Any Doctorate - Any Specialization
Job Related Keywords
Medical Claims
Health Insurance
Claims Adjudication
Medical Evaluation
Clinical Review
Medical Audit
Utilization Review
Insurance Claims
Medical Documentation
Clinical Documentation Review
Medical Records Analysis
Medical Necessity Assessment
Health Insurance Claims