Medical Claims Review Analyst - Bengaluru
5 days ago

Job summary
The Medical Advisor is a member of the medical team which develops and manages health and wellness programs for Cigna customers.
Responsibilities
- Evaluates medical information against criteria, benefit plan, coverage policies and determines necessity for procedure and refers to Medical Director if criteria are not met
- Evaluate itemized bills against reimbursement policies
- Adheres to quality assurance standards
- Serves as a resource to facilitate understanding of products
- Handles some escalated cases; secures supervisory assistance with problem solving and decision making/li>Advises supervisory staff of any concerns or complaints expressed by Health Care Professionals(li>Utilizes effective communication, courtesy and professionalism in all interactions, both internally and externally/li>
Job description
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