Overview Medical Officer – Inpatient Precertification is responsible for managing the Inpatient Precertification cases while ensuring that departmental goals, timelines, and compliance measures are met.
What you do - Precertification team is functional 24/7. Therefore the Medical Officer will be working on a flexible shift basis as per the schedule provided by the Team Leader.
- Adjudicates cases at the IP precertification level, authorizes decisions within the stipulated turnaround time and with the highest quality standards in view of the policy terms and conditions.
- Perform complete file review with regard to multidisciplinary notes, TPR charts, physician order notes, lab reports, radiology reports, drug chart sheets, consultation notes, nursing notes, progress notes, etc.
- Request any medical documentation or find any missing documents essential for decision making.
- Perform review of DRG Severity of Illness (SOI) i...