Job Description - HCD- A2
Specifically in Claims adjudication, claims processing, pricing, administrative records review experience pertinent to US Healthcare PAYOR domain,
Medical Records Management, Clinical Audit based on Medical Records Review, Seasoned experience in US Healthcare (Payer/Provider LOB).
Preferred to have worked over a period of time in US Healthcare payer/provider domain. Understand the business model for our delivery center and then implement the same in the training vertical. Should have effective communication skills to coordinate with program SMEs and candidates. Should be well accustomed with reporting, presentations, creating training materials (videos/document) in granular level. Should possess understanding of High Cost Drug and Durable Medical equipment auditing through Medical records review.
Previously working for US Healthcare Payer vertical/LOB will be an added advantage.
- Follow every aspect of SOP without fail
- Complete received Audits with Quality
- To meet the team/Client Quality and 100% of production target on a daily basis
- Follow project related protocols and instructions
- Escalate issues, identify trends...
- Update all the logs like productivity, Clarification log, and any other logs applicable on a daily basis.
- Should be read to extend support working on weekends a and when applicable.
- Should be a good team member to ensure the smooth service delivery.
- Should be a good and fast learner
- All emails from Leads, Team members, Manager and higher hierarchy should be answered promptly without fail
- Ensure Healthcare compliance of entire team for HIPAA,OIG,PHI etc.
