Hospital Auditor Mumbai

7 days ago

Mumbai, India MediEnsure Pvt Ltd Full time

**Greetings From MediEnsure Pvt Ltd**

**Job Title: Hospital Auditor**

**Primary Role**:
As a hospital auditor, the primary role is to evaluate medical claims made by hospitals to ensure that they are medically necessary and accurately billed based on the policies and protocols of the health insurer. They also play a key role in identifying and preventing fraudulent claims by cross-referencing multiple claims and reviewing medical records in detail.

**Responsibilities**:
The primary responsibilities of a hospital auditor are:
1. Conduct audits of medical claims submitted by hospitals to ensure accuracy and appropriateness.

2. Verify the medical necessity of procedures and treatments performed on patients.

3. Identify and report fraudulent billing practices.

4. Evaluate compliance with industry regulations, such as HIPAA and Medicare/Medicaid standards.

5. Analyze medical records to determine if the care provided meets industry standards and best practices.

6. Prepare reports to present audit results to hospital management and health insurer leadership.

7. Communicate with hospital staff and physicians to ensure that they are aware of the audit process and any changes to policies or procedures.

8. Provide support and guidance to hospital staff to help them understand industry regulations and billing practices.

9. Monitor and evaluate trends in claims data to inform policy changes and improve the overall efficiency and effectiveness of the health insurer's operations.

Qualifications:
The qualifications required for a hospital auditor working for a health insurer are:
1. Bachelor's degree in health care management, finance or related field.

2. Knowledge of medical billing codes and insurance industry standards.

3. Ability to read and interpret medical records and claims documents.

4. Experience conducting audits and reviewing financial statements.

5. Excellent analytical skills and attention to detail.

6. Excellent communication skills, both written and verbal.

7. Ability to work independently and within a team environment.

8. Understanding of healthcare industry regulations and quality improvement standards.

9. Proficiency in using computer and data analysis software.

**Job Types**: Full-time, Regular / Permanent

**Salary**: ₹300,000.00 - ₹400,000.00 per year

Schedule:

- Monday to Friday
- Weekend availability

**Speak with the employer**
+91 8630533811

  • Internal Auditor

    5 days ago

    Mumbai, India TopGear Consultants Full time

    **Dear All,** **Hiring for a leading company **Job Role : Internal Audit** **Job Location : Mumbai** **15 days Travelling Pan India Compulsory** **Education : CA - 1st Attempt only** - Preparation of financial statements. - Preparation of analyticals w.r.t. financial performance - Preparation for various information required for bidding purpose for...

  • Internal Auditor Mumbai

    1 week ago

    Bhandup, Mumbai, Maharashtra, India SV Placement Full time

    3 - 6 years - Bhandup - Mumbai - 4,00,000 - 6,50,000 Internal or Process Auditor is responsible for auditing in various department like Purchase, HR, Accounts & Finance Etc... Auditor should capable to find mistakes of particular department. **Role & Responsibilities**: - Opening- 1- Employment Type- Full-Time- Industry Type- Textile & Apparel- Functional...

  • Internal Auditor

    4 weeks ago

    Navi Mumbai, India Prime Placement Mumbai Full time

    The Internal Auditor will oversee the financial and operational compliance of export-import transactions, including documentation, statutory compliance, bank dealings, and risk control. government regulations.

  • Hospital Receptionist

    2 weeks ago

    Sanpada, Navi Mumbai, Maharashtra, India Hospital Staff Full time

    URGENTS REQUIREMENTS FOR RECEPTIONIST LOCATION - SANPADA QUALIFICATION - GRADUATE EXPERIENCE - SHOULD HAVE KNOWLEDGE ABOUT IPD AND OPD, BILLING ETC HOSPITAL EXPERIENCE REQUIRE SALARY - 10000 - 13000 DAY ROTATION SHIFT IMMEDIATE JOINERS Pay: ₹10,000.00 - ₹13,000.00 per month Schedule: - Day shift - Rotational shift **Experience**: - Microsoft...

  • Auditor

    3 days ago

    Mumbai, Maharashtra, India Ananta resource Management Full time

    Hiring for: - Internal auditor - 0-5years of experiemce - skills - INDAS, internal audit,manufactuirng exp - ctc - 10-15lpa - loc - Andheri,mumbai - Statutory and bank auditor - 3-5 yrs of exp - skills-Statutory audit,bank audit - loc - Andheri,mumbai - ctc-10-16lpa **Job Types**: Full-time, Permanent Pay: Up to ₹1,500,000.00 per year Schedule: - Day...

  • Auditor

    1 day ago

    Mumbai, India OSOURCE GLOBAL PVT LTD Full time

    Dear All We have urgent opening for Auditor for Navi Mumbai Mahape location. Any audit experience will work Advantage to have expereince in CA firm. Kiran 8076618771 **Salary**: ₹10,000.00 - ₹400,000.00 per year **Benefits**: - Provident Fund Schedule: - Monday to Friday Ability to commute/relocate: - Mumbai, Maharashtra: Reliably commute or...

  • Lab Technician Srv Hospital

    1 week ago

    Chembur, Mumbai, Maharashtra, India SRV Hospital Full time

    Pathology Lab Technician at SRV Hospital Kurla, Chembur Near Tilak Nagar Station SRV Group of Hospital Multispeciality with 500 Beds across Banglore, Nasik, Mumbai-Goregaon, Dombivali, Kurla Tilak nagar is seeking applicants Interview Details - Interview Timing - 2:30Pm - 4:30Pm Interview Location - SRV Chembur 320 shell Colony Tilak Nagar Chembur Mumbai...

  • Registered Nurse and midwifery

    4 weeks ago

    Mumbai, India Holy Spirit Hospital (Mumbai) Full time

    Company Description Holy Spirit Hospital, located on Mahakali Caves Road in Andheri East, Mumbai, is a biotechnology-focused healthcare provider. The hospital is renowned for its state-of-the-art facilities and commitment to quality care. We prioritize patient-centric services and are committed to advancing healthcare through innovative solutions and...

  • Auditor-1

    1 day ago

    Mumbai, India Deutsche Bank Full time

    **Job Title**:Auditor - Associate/Analyst **Location**:Mumbai The **Audit Analyst/Auditor **will be initially working with the various teams supporting the coverage of Indian and other APAC legal entities and processes. After the initial training and development phase, the Audit Analyst/Auditor will eventually join one of the global audit teams on a...

  • Pro for Hospital

    1 week ago

    Mumbai, Maharashtra, India millennium hospital ulwe Full time

    Achieving revenue targets Field Job of approaching Consultants / institutions etc for developing business. - Meeting with Consultants & General Practioners at least 10 to 12 per day for explaining our various procedures and requesting referrals. - Tie ups with small Hospitals & other institutions for business. Corporate tie-ups, follow-ups & renewals. - To...