Job Description
Position- Senior Specialist QC
Job Location - Mumbai/Vadodara
Job Description -
Ensure claims are adjudicated in compliance with provider contract parameters, member demographic information, and service level requirements through random sample audit and targeted claim reviews
Mark errors made by production team and check whether corrections are made into the system after feedback
Compile data, perform audit, interpret and report back results to Quality Head
Provide monthly/quarterly/yearly feedback used for optimizing client reporting and employee performance measurement
Participate in documenting and prioritizing potential solutions to issues & fallout for system issues
Assist in establishing, updating, and communicating any change in the existing procedures
Education
Graduate in any stream
Training/Work experience
Billing & collections training and/or 1 year of industry experience in the relevant function
Other specifications
Good English communication (reading, writing)
Understanding of US healthcare, HIPAA
Good at Operating Computer - software and MS office
Capable of task execution based on work instructions
Apply Here-
https://primepeople.darwinbox.in/jobs/jobsdetailed/id/a63aade4069a6a/grp_company/a630471e0e6203