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

Responsibilities

• Precertification team is functional on a 24/7 basis. Therefore 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 with the highest quality standards in view of the policy terms and conditions.
• Performs a complete file review with regard to the multidisciplinary notes, TPR charts, physician order notes, lab reports, radiology reports, drug chart sheets, consultation notes, nursing notes, progress notes, etc.
• Requests any medical documentation or identifies any missing documents essential for decision making.
• Performs review of DRG Severity ...