Subject Matter Expert

3 days ago

Pune, Maharashtra, India Cotiviti Full time

Cotiviti Hiring Subject Matter Expert (SME) Program: Coding Validation

Educational Qualification : MBBS / BAMS / BHMS / BPT

Certification : CPC certification is mandatory (CPC Pursuing Candidates can also apply.

Relevant Experience : E&M or IPDRG Speciality candidates are preferrable

Experience : Min 3+ Years

Position Summary

SME will be responsible for analyzing and interpreting the correct codes for the descriptions available on various medical procedures and diagnosis and other related medical coding as per the medical policy requirements, ensuring work delivery as per set expectations while maintaining the required quality standards. Also, the SME would be responsible for extending process training sessions to New Hire Staff in accordance with the Organization Standards.

Key Responsibilities

  • Conducting Training sessions & Floor Support:
  • Conduct NH training program for all newly onboarded staff with the program in accordance with Organization Standards
  • Help train new hires on both claims & appeals (as needed) and provide support in the OJT Phase
  • Takes charge of ongoing learning and development and participates in relevant training and development activities
  • Actively involved in internal communications to keep the process knowledge at par with the process standards
  • During the initial phase, the selected candidate will work US hours. Once the training transition is completed, the candidate will be expected to work in blended shifts
  • Assist Team Coaches in ensuring that all SOPs and training documents are updated with changes in a timely manner and communicates all updates to the team

Flex QA:

  • While not in active training sessions, the selected candidate is expected to work on Flex QA supporting the business in checking the quality standards for the volume processed by analysts
  • Monitor accuracy rates for assigned clients and assist management in proactively detecting negative deviations & working on remediation plan

Interested candidates can apply or call the below number.

Regards,

Abdul Rahuman

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