5 Clinical Review Jobs

Roles and Responsibilities Entering of patient demogrpahics and insruance information. Verifying Insurance Policy coverage from the webportal. Order Corrections for the screnrios : Changes in the calories, different product, Hospital Re-admit, discharge, patient expired. Delivery Worksheet : Orders are being picked from the Patient Medical records Monthly facility billing (PART A Report ) and MA reports are prepared and sent to the client. Develop understanding of client specifics and requirements File are split and renamed as per the client naming convention. Renamed Invoices are allocated to the users for further tasks Based on the Invoice, users should reconcile or enter the PO in the accounting application. Following up with clients on Invoice clarification Understand special situations and procedures that relate to the client we work on. Performs other duties as assigned. Desired Candidate Profile Education, Training, and Experience Required: Bachelors Degree or 3 year Diploma or equivalent is required. Medical Transcription experience is a huge plus Two (2) years of Medical Billing DME Billing, Charge Entry, Payment Entry experience is preferred; Equivalent combination of experience, education, and training that would provide the required knowledge and abilities. Knowledge/Skills: Knowledge of medical terminology; anatomy and ; English grammar and usage. Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations. Ability to read and interpret medical billing clinical notes Ability to develop training materials, make group presentations, and to train staff Ability to exercise independent judgment; Excellent written and verbal communication skills to prepare reports and related documents and to maintain working relationships with physicians and other staff. Ability to competently use Microsoft Office Suite, particularly Word, Excel and Outlook. Ability to maintain confidentiality. Perks and Benefits As per market standards

Position Reports To : Medical Team Lead Department : Operations Position Summary : - The role will be to review and verify large volumes of patient's full medical records with precision, perform clinical reviews as defined by the specific review methodologies and prepare a detailed report that includes chronologies and timelines, summaries, mass tort matrix and medical opinions on case validity and valuation. Job Responsibilities : - Analyzing and summarizing medical records for pre and post settlement projects. Interpreting clinical data in terms of medical terminology and diagnosis. o Adhering to company policies/ARCHER principles and hence taking good care of Archer culture. Adhere to Health Insurance Portability and Accountability Act (HIPPA) all the time. Daily reporting to Medical team lead for productivity & quality Knowledge, Skills And Abilities : - Technical Skills: Knowledge of basic level of health care data analysis and clinical review. o Sound knowledge of medical terminology, assessments, patient evaluation, and clinical medicine. Ability to work proficiently with Microsoft Word, Adobe, and Excel. Interpersonal Skills: Ability to perform well in a team environment, with staff at all levels, to achieve business goals. Ability to function under pressure and with deadline-oriented project demands as well as manage multiple initiatives. Team player and motivated self-starter. o Detail-oriented, organized, able to multi-task. Effective communication skills. Educational Qualification And Experience Required : - MBBS graduate (No experience required) BHMS/BAMS graduate (Minimum 2 years of experience with Claims Processing in the Insurance sector). Additional Skills : - HIPPA, Critical thinking, Basic understanding of US culture, Basic understanding of organization culture and behavior. Career Path : - Medical Officer Medical Team Lead

Mandatory: Ideal candidates would be BSc Nursing/Post BSc/Msc Nursing - with 1-2 YEARS of overall Experience in nursing.

Greetings from Sagility. Job Description: Able to Interpret all types of Medical records Interpret medical necessity in contrast to clinical policies / guidelines Interpret medical data and provide accurate clinical review Identify Cost Savings within Medical Claims Itemized bill review (IBR) for Institutional claims Team handling experience Qualification & Skills: BDS\MBBS\BPT International Healthcare exposure Willing to Work from Office 5 days working in a week Immediate Joiners are Required. Interested candidates can share your resume to anitha.c@sagilityhealth.com

Greetings from Sagility. Job Description: Able to Interpret all types of Medical records Interpret medical necessity in contrast to clinical policies / guidelines Interpret medical data and provide accurate clinical review Identify Cost Savings within Medical Claims Itemized bill review (IBR) for Institutional claims Team handling experience Qualification & Skills: BDS\MBBS\BPT International Healthcare exposure Willing to Work from Office 5 days working in a week Immediate Joiners are Required. Interested candidates can share your resume to anitha.c@sagilityhealth.com