Phoenix Assurance Pvt Ltd
Website:
phoenixassurance.in
Job details:
🚨 **WE ARE HIRING – DESK AUDITOR (Hospital Audit Project)** 🚨
🏢 **Company:** **Phoenix Assurance Pvt. Ltd.**
💼 **Position**
**Desk Auditor – Hospital Audit Project**
📍 **Job Location:** **Work From Office / Work From Home**
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⏰ **Working Hours**
🕙 **10:00 AM – 6:30 PM**
📅 **Working Days**
* **Monday to Saturday**
* **Sunday Off**
🌴 **Leave Benefits**
✔️ **1.5 Paid Leaves per Month**
💰 **Salary**
**Up to ₹40,000/- per Month** *(Based on Experience & Interview Performance)*
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🎯 **Key Responsibilities**
* Conduct **desk audits** of hospital claims by reviewing medical records, tariffs, treatment packages, and policy compliance within the prescribed TAT.
* Perform detailed verification of medical documentation to identify discrepancies, overbilling, and policy deviations.
* Allocate audited claims to the Field Audit Team and ensure **100% case coverage within TAT**.
* Supervise and guide Field Auditors during hospital visits, documentation, and audit execution.
* Coordinate with hospitals, insurance companies, and internal teams to obtain clarifications and required documents.
* Identify **billing leakages, tariff discrepancies, package deviations, policy violations, and suspected Fraud, Waste & Abuse (FWA)** cases.
* Escalate fraud indicators, high-value leakages, and critical findings to senior management on time.
* Act as the primary coordination point between the insurer, hospitals, and internal teams throughout the audit process.
* Review and validate field audit findings before final submission.
* Prepare comprehensive audit observations and submit closure reports within the defined timelines.
* Maintain daily MIS reports, audit trackers, and productivity reports.
* Ensure compliance with company SOPs, client requirements, and regulatory guidelines.
✅ **Eligibility Criteria**
* **Qualification (Mandatory):**
* **MBBS** *(FMG Candidates Welcome – GMC Registration Not Required)*
* **BHMS / BAMS**
* **Experience:** Minimum **1–2 Years** of experience in Hospital Audit, Medical Audit, Health Insurance Claims, or Clinical Operations preferred.
* Strong clinical knowledge and understanding of hospital treatment protocols.
* Good knowledge of health insurance claims, medical documentation, tariffs, and package audits.
* Good computer skills and proficiency in **MS Excel, MS Office, and Google Sheets**.
* Excellent analytical, communication, and coordination skills.
* Ability to work independently and manage multiple audits within TAT.
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⭐ **Why Join Phoenix Assurance?**
✔️ Opportunity to work on prestigious Hospital Audit Projects.
✔️ Exposure to leading Insurance Companies and TPAs.
✔️ Career growth in Medical Audit & Health Insurance.
✔️ Professional and performance-driven work environment.
✔️ Learning opportunities in Fraud Detection, Clinical Audit, and Healthcare Compliance.
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⚡ **Immediate Joiners Preferred**
📩 **Apply Now**
📧 **(mailto:hr@phoenixassurance.in)**
📞 **+91 63588 67436**
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**Phoenix Assurance Pvt. Ltd.**
**Building Trust Through Professional Insurance Investigation & Claim Verification**
Click on Apply to know more.