Medical Insurance Officer

The Medical Insurance Officer course is one of its kind in India and is developed to help aspirant medical graduates to pursue their careers in the field of health insurance management. It covers the entire spectrum of the health insurance claim processing cycle and equips the aspirant to effectively and efficiently manage the health insurance claim processing and settlement both at the hospital side as well as the insurance company/ TPA side. The one-month personal contact programme at the institute and internship in front-line hospitals will give you real-time exposure and experience to take over the role from the very beginning of your career.

Program Outcome:

• Understanding of Health and Healthcare from the Perspective of Health Insurance
• Understanding Health Insurance Operations from the Perspective of Providers as well as TPAs /Insurers
• Develop an understanding of various health insurance products and other add-on services, Key Terms and Clauses of Insurance policies, general inclusions, and exclusions of Health Insurance Policies, and Legal aspects of Health Insurance.
• To describe the management of health insurance claims and its stakeholders, cashless claims and reimbursement claims, the TPA functions and responsibilities, various government health schemes, and social health insurance schemes.
• Equip Doctors for various role functions in TPAs/Insurance Companies /TPAs, Claim Management/Audit/Investigation/Provider Contracting, etc.
• Gain an understanding of the basics of human anatomy and physiology, common systemic diseases, different disciplines of healthcare organization/ specializations regarding the human body, various Laboratory Tests/investigations/Imaging Technologies commonly used in the management of diseases and understand the various Support Services involved in Disease Management in hospitals.
• Display soft skills and people skills to tackle professional situations and understand the functioning of HIS/EMR, describe the Medical Coding practices and their importance/applicability in Health Insurance management.