Posted:2 weeks ago| Platform: SimplyHired logo

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On-site

Job Type

Full Time

Job Description

Must be a certified nursing professional (GNM/B.Sc Nursing/MBBS/BAMS/BHMS) with a valid Indian medical/nursing degree - Mandatory

1–2 years of experience in a supervisory or quality role in a US healthcare BPO/KPO process (e.g., claims, RCM, utilization review) - Preferred

Strong understanding of US healthcare workflows such as claims adjudication, prior authorization, clinical documentation, or medical coding - Preferred

Excellent medical judgment and clinical knowledge to support case reviews, escalations, and documentation validations - Mandatory

Good communication skills to liaise between operations, QA teams, and US-based clients or providers

Experience in process audits, compliance checks, and training new hires on clinical guidelines

Familiar with HIPAA regulations, EMR/EHR systems, and US insurance terminologies and ICD/CPT codes - - Preferred

Job Type: Full-time

Pay: ₹30,000.00 - ₹40,000.00 per month

Work Location: In person

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