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For Employers

Clinical Supervisor

Abhinav Institute of Technology and Management

12 - 16 years

0 Lacs

nagpur maharashtra

Posted:1 week ago| Platform: Shine logo

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Skills Required

gnm bsc nursing bams bhms claims adjudication prior authorization clinical documentation medical coding certified nursing professional mbbs us healthcare workflows hipaa regulations emrehr systems us insurance terminologies icdcpt codes

Work Mode

On-site

Job Type

Full Time

Job Description

As a certified nursing professional, you must hold a valid Indian medical/nursing degree (GNM/B.Sc Nursing/MBBS/BAMS/BHMS). Additionally, you should possess 12 years of experience in a supervisory or quality role within a US healthcare BPO/KPO process, particularly in areas such as claims, RCM, or utilization review. Having a strong understanding of US healthcare workflows, including claims adjudication, prior authorization, clinical documentation, and medical coding, is highly preferred. Your role will require excellent medical judgment and clinical knowledge to support case reviews, escalations, and documentation validations. Effective communication skills are essential for liaising between operations, QA teams, and US-based clients or providers. Previous experience in conducting process audits, compliance checks, and training new hires on clinical guidelines will be beneficial. Ideally, you should be familiar with HIPAA regulations, EMR/EHR systems, and US insurance terminologies along with ICD/CPT codes. This knowledge will help you navigate the complexities of the US healthcare system efficiently. This position is full-time and requires your presence at the work location in person.,

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Clinical Supervisor