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4 days ago
This position is responsible for reviewing, analyzing and interpreting medical information to assess and determine appropriate next action steps which may lead to denial or payment of claims.
The work is performed under general supervision according to established guidelines. This individual promotes capabilities from a customer perspective, aligning needs with the target offering by creating a customer self-service enabled platform for core customers.
Key Responsibilities- Responsible for reviewing and analyzing discrepancies by cross-verifying from different data sources
- Familiar with US Healthcare domain knowledge and understanding of healthcare regulations (HIPAA)
- Deep understanding of medical coding, billing, and medical terminologies
- Attention for detail, and Strong analytical skills for processing medical documentation
- Critical thinking and high independent decision making capability
- Proficiency in healthcare information systems
- Ability to navigate through multiple applications
- Operates with urgency in a real time service environment
- Meets individual goals while assisting team to meet team goals
- Productivity
- Quality
- Turn Around Time of work assigned
- Attendance & Schedule Adherence
- Reports To: Assistant Manager/Lead Assistant Manager
- Critical thinking and high independent decision making
- Strong analytical, Reasoning, and Problem solving skills
- Ability to comprehend and write in English for structured written communications. Emails/IMS to be sent to internal teams
- Strong interpersonal and communication skills - both verbal and written
- Ability to understand and question established process guidelines for possible process improvements
- Attention for detail, and Strong analytical skills for processing medical documentation
- Possess keen sense of acquiring knowledge
- Adaptable and flexible to work in night shifts
Education Requirements and Work Experience:- Bachelor's degree in relevant field such as Biology, Biochemistry, Biotechnology etc
- Computer literacy
- Candidates with relevant business experience will be preferred
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