Medical Reviewer

This role is a medical reviewer responsible for verifying the accuracy of patient medical records. The incumbent will investigate and detect fraudulent activity perpetrated by providers, members, and facilities.Key Responsibilities:Verify medical records for completeness and accuracyConduct investigations to identify fraudulent activityGather information...

Job OpportunityWe are seeking highly skilled professionals to join our team in a key role of reviewing and denying medical claims that do not meet our criteria.Key Responsibilities:Minimum 3+ years of experience in relevant fields is required.Certification is mandatory for this position.Excellent knowledge of medical coding terminology and work processes is...

Job DescriptionRole Overview:We are hiring Medical Coding Associates to ensure accurate translation of healthcare diagnoses, procedures, and medical services into standardized coding systems. The role involves reviewing medical documents, assigning correct codes, and ensuring compliance with healthcare regulations.Responsibilities:- Review and analyze...

Hi All,We are seeking a detail-oriented and knowledgeable professional to join our Billing Rejection team. The ideal candidate will have a strong understanding of medical billing processes, rejection handling, and coding standards (ICD-10, CPT, HCPCS). This role involves analyzing rejected claims, identifying root causes, and coordinating with internal teams...

We are seeking an experienced Medical Coder with a strong background in Cardiology coding to join our growing team. The ideal candidate will possess deep knowledge of cardiovascular procedures and diagnostic codes, ensuring accurate and compliant coding to optimize reimbursement and maintain regulatory standards.Key Responsibilities:Accurately assign...

Job Title: Claims Review SpecialistWe are seeking a skilled Claims Review Specialist to join our team. As an integral part of our organization, you will play a vital role in reviewing and analyzing medical claims to ensure accuracy and compliance with payer guidelines.Your key responsibilities will include reviewing itemized bills and claims for accuracy and...

Hiring for Nursing Graduates for Clinical reviewer Position. Responsibilities:-1) You will be working for health insurance organization2) Ensures healthcare services align with evidence, standards, and guidelines,3) Aiming to improve quality, safety, and efficiency while reducing unnecessary costs4) Good anatomical and clinical knowledge5) Good language and...

JOB DETAILS 1 Develop and maintain in-depth knowledge for assigned product(s) / relevant therapeutic area(s) through attendance/ participation at key internal meetings/training sessions, relevant congresses, and seminars and by regular self-study of the national/international literature.2 Provide expert medical/scientific advice for assigned products and...

About this role:We're seeking a highly skilled Medical Expert to join our team. This is an exciting opportunity to leverage your medical knowledge and diagnostic abilities to fine-tune large language models.As a Medical Practitioner, you will work on advanced medical problems, creating clear explanations of complex cases. Your tasks may include diagnostic...

JOB DETAILS 1) Excellent opportunity for MBBS,BDS,BSMS,BHMS in Medical Coding Process for our Healthcare Services Division.2) To review US medical records3) Initial file review for identifying merits4) Subjective review and analysis to identify instances of negligence, factors contributing to it5) To review surgical procedures, pre and post-surgical care,...