Medical Officer | IP

Medical Officer – Inpatient Precertification is responsible for managing the Inpatient Precertification cases while ensuring that departmental goals, timeline of activities, and compliance measures are met.

What You Do

• Precertification team is functional on a 24/7 basis, so the Medical Officer will work on a flexible shift basis as per the schedule provided by the Team Leader.
• Adjudicates cases at IP precertification level, authorizing decisions within the stipulated turnaround time and maintaining the highest quality standards in view of the policy terms and conditions.
• Performs complete file review including multidisciplinary notes, TPR charts, physician orders, lab reports, radiology reports, drug chart sheets, consultation notes, nursing notes, and progress notes.
• Requests any required medical documentation or identifies missing documents essential for decision making.
• Reviews DRG Severity of Illness (SOI) in lin...