Trainee - Medical Reviewer

1 day ago

Bengaluru Karnataka, India OMH HealthEdge Holdings Full time

Omega Healthcare Management Services Private LimitedkarnatakaPosted On
- 26 Sep 2024
- Required Experience
- 1 - 3 Years
Basic SectionNo. Of Openings

15

Grade

1A

Designation

TRAINEE - MEDICAL REVIEWER

Closing Date

31 Dec 2024
- OrganisationalCountry

IN

State

KARNATAKA

City

BENGALURU

Location

Bengaluru-I
- SkillsSkill

ACCOUNTS RECEIVABLE

BPO

PROCESS IMPROVEMENT

MIS

MEDICAL BILLING

VENDOR MANAGEMENT

ACCOUNTING

FINANCIAL ANALYSIS

OUTSOURCING

CRM

Education Qualification

No data available

CERTIFICATION

No data available
- Job DescriptionMedical Reviewer Job Description
We are seeking talented and experienced Medical Reviewers to join our Healthcare BPO team. As a Medical Reviewer, you will play a crucial role in ensuring the accuracy and completeness of medical documentation for our clients, which include healthcare providers, insurance companies, and other organizations in the healthcare industry.

**Responsibilities**:
Review and analyze medical records, clinical notes, diagnostic reports, and other healthcare documentation provided by clients
Verify the accuracy and completeness of medical information, ensuring compliance with industry standards and coding guidelines
Identify any discrepancies, errors, or inconsistencies in the documentation and provide feedback for correction or clarification
Collaborate with coding professionals, healthcare providers, and other stakeholders to resolve issues and ensure data integrity
Maintain up-to-date knowledge of medical terminology, coding systems (ICD, CPT, HCPCS), and regulatory requirements
Ensure strict adherence to HIPAA guidelines and client confidentiality protocols
Prepare detailed reports summarizing findings and recommendations for each review case
Participate in quality assurance and process improvement initiatives within the BPO team
Meet productivity and turnaround time targets while maintaining high accuracy standards

**Requirements**:
Registered Nurse (RN) or Medical Doctor (MD) degree from an accredited institution
Minimum of 3 years of experience in medical record review, coding, or healthcare documentation
Comprehensive knowledge of medical terminology, anatomy, physiology, and disease processes
Strong understanding of coding guidelines and healthcare regulations (e.g., HIPAA, ICD-10, CPT)
Excellent attention to detail and analytical skills
Effective communication skills, both written and verbal
Ability to work independently and meet deadlines in a fast-paced environment

Preferred Qualifications:
Certification in medical coding (CPC, CCS) or healthcare documentation (RHIA, RHIT)
Experience in a specific medical specialty or healthcare setting (e.g., inpatient, outpatient, billing)
Familiarity with medical auditing processes and quality assurance procedures
Knowledge of healthcare process outsourcing operations and best practices

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