Medical Audit Executive
1 month ago
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 LeadDepartment: OperationsJob Locations: Vadodara, IndiaJob 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 toreview the medical records (CPL - Conditional Payment Letter) and performnecessary 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 qualitycheck.2. Responsibilities / KRAs ( list down primary responsibilities for this role):-
Review medical document (CPL) available in LPM as per the audit protocol, Code setand 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 workenvironment.-
Adhering to company policies/ principles and hence taking good care ofculture.List the other roles (designations) with whom this job incumbent must interact to deliver on day-to-day responsibilities:Medical Audit TeamTeam LeadAssistant Manager - OperationsManager - OperationsTraining or Quality Team Members3. Role Holder - Skills Criteria:Technical skills required Behavioral skills required-
Typing speed of 30 WPM-
Communication Skill - Email writing-
Basic knowledge of MS office applicationslike MS Excel, MS word and MS PowerPoint-
Flexible enough to work cross- functional-
Research and Analytic Skill-
Learning capabilityExperience: 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 etcExcel, Call & Email Etiquettes, PowerPointTraining - Describe the various soft skills training required to perform this role effectively, eg:Communication Skills etcBasic understanding of US culture,Basic understanding of organization culture and behaviorEducation and Qualifications - GraduateCareer Path (Kindly list one or two options for an individual who becomes a specialist in this roleto progress in this organisationIf he/she is performing good in the current role, may grow to Associate Operations - II or Sr.Associate - OperationsAdditional NotesAn individual should be self-motivated and flexible
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