Medical Audit Executive

3 weeks ago

Vadodara, India Asian Hires Full time

We will only accept candidates from Vadodara; aspirants from other states will not be considered. For that reason, if you are not from Vadodara, kindly do not apply.


Position Reports to: Team Lead

Department: Operations

Job Locations: Vadodara, India

Job Description:

1. Job Role (Brief description of the overall purpose of this role):

• Being a part of very complex yet important process, the associate is responsible to

review the medical records (CPL - Conditional Payment Letter) and perform

necessary action as per the process. Taking the lien resolution to the further level.

He/she will ensure that the correct information captured in CPL (Approved/Denial),

transcribed accurately, and point out the process anomaly and perform quality

check.


2. Responsibilities / KRAs ( list down primary responsibilities for this role):

• Review medical document (CPL) available in LPM as per the audit protocol, Code set

and capture Approved/Denial charges in CPL of the claimant.

• Need to achieve 100% accuracy by following SOP and audit protocol.

• The candidate is expected to be well-organized and creating positive work

environment.

• Adhering to company policies/ principles and hence taking good care of

culture.


List the other roles (designations) with whom this job incumbent must interact to deliver on day-

to-day responsibilities:


Medical Audit Team

Team Lead

Assistant Manager - Operations

Manager - Operations

Training or Quality Team Members


3. Role Holder - Skills Criteria:


Technical skills required Behavioral skills required

• Typing speed of 30 WPM • Communication Skill - Email writing

• Basic knowledge of MS office applications

like MS Excel, MS word and MS PowerPoint


• Flexible enough to work cross- functional


• Research and Analytic Skill • Learning capability

Experience: 1 - 2 Years of experience into MNC or US/ EU based BPO / KPO.

Training: Describe various technical training which are critical to perform this role effectively, eg:

Excel, Project Management etc

Excel, Call & Email Etiquettes, PowerPoint

Training - Describe the various soft skills training required to perform this role effectively, eg:

Communication Skills etc

Basic understanding of US culture,

Basic understanding of organization culture and behavior

Education and Qualifications -

Graduate

Career Path (Kindly list one or two options for an individual who becomes a specialist in this role

to progress in this organisation

If he/she is performing good in the current role, may grow to Associate Operations - II or Sr.

Associate - Operations

Additional Notes

An individual should be self-motivated and flexible

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