Hiring For Manager & Sr. Manager- Medical Audit Virtuoso Staffing Solutions

6.0 - 11.0 years

10 - 12 Lacs

New Delhi, Gurugram, Delhi / NCR

Work from Office

Roles and Responsibilities Conduct medical audits for high-value claims, including inpatient and outpatient services. Review NCCI guidelines to ensure accurate coding and compliance with US healthcare regulations. Analyze CPT codes to identify discrepancies and optimize claim processing. Collaborate with internal stakeholders to resolve issues related to claims adjudication. Develop expertise in dollar value claims handling, focusing on accuracy and efficiency. Desired Candidate Profile 6-11 years of experience in Medical Audit or Claims Auditing/Audition role. Strong understanding of CPT, ICD-10-CM/PCS, HCPCS Level II codes; knowledge of anesthesia codes (G0152) preferred. Experience working with High Value Claims (HVC) is essential; familiarity with NCCI guidelines a plus.

Posted 3 weeks ago

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Senior Claims Manager - Mumbai Vandana Sharma

5.0 - 10.0 years

8 - 13 Lacs

Mumbai, Mumbai (All Areas)

Work from Office

Handle quality audits of Death/CI claims & Check ensure regulatory/customer/business/process norms are met Timely closure ATR audits Check, propose feasible changes/improvements avoid failure/leakages in claim process, reports, Required Candidate profile Role involves collating entire data present to Management, Managing dashboards & initiating various strategies to improve existing process enhance the functioning of the department

Posted 1 month ago

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