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0.0 - 3.0 years

0 Lacs

indore, madhya pradesh

On-site

As a Junior Healthcare Operations Analyst at our organization, you will play a crucial role in ensuring the efficient operations of the medical/healthcare office. Your responsibilities will include understanding and interpreting medical terms, reviewing provider and patient notes, working on medical coding, reviewing medical records, and collaborating with on-site client teams. You should demonstrate proficiency in medical terminology and coding procedures (ICD-10/CPT) to accurately communicate complex medical information and ensure proper patient billing. Task management and execution are key aspects of your role, requiring you to perform assigned tasks across various healthcare processes with accuracy, timeliness, and compliance with SOPs. Supporting day-to-day operational workflow activities, collaborating with teams, and adapting to new tasks or process assignments are essential for maintaining operational efficiency. Utilizing MS Excel and Power Point, you will analyze healthcare data, prepare reports, and maintain data logs to support reporting and ensure compliance with quality benchmarks and HIPAA standards. Collaboration with peers and leads for workflow alignment, problem-solving in healthcare contexts, and effective communication with on-site client teams are integral parts of your role. You should possess excellent verbal and written communication skills, attention to detail, and the ability to work independently with minimal supervision. Your knowledge of medical office management systems, time management skills, proficiency in MS Office, and experience in medical assistance within the US Healthcare System will be beneficial. Familiarity with electronic medical health care record systems, ICD-10 and CPT codes, and experience in medical billing, coding, or medical transcripts are preferred. If you are persistent, patient, enthusiastic, and possess excellent interpersonal, organizational, and customer service skills, we encourage you to consider this opportunity to contribute to our team's success.,

Posted 17 hours ago

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0.0 - 3.0 years

3 - 15 Lacs

Trichy, Tamil Nadu, India

On-site

Preferred Skills, Education, and Experience: Any graduate Good communication skills and fair command of English language Experienced in AR Follow-up and Denials Management Good understanding of the US Healthcare revenue cycle and its intricacies Excellent analytical and comprehension skills Roles and Responsibilities: Review providers claims that have not been paid by the insurance companies Follow-up with Insurance companies to understand the status of the claim - Initiate telephone calls or verify through payer websites or otherwise request the required information from insurance companies. Contact insurance companies for further explanation of denials and underpayments and where needed, prepare appeal packets for submission to payers Based on the responses/ findings, make the necessary corrections to the claim and re-submit/ refile as the case may be Document actions are taken into claims billing system Meet the established performance standards daily Improve skills on CPT codes and DX Codes. Make collections with a convincing approach.

Posted 3 days ago

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0.0 - 3.0 years

3 - 15 Lacs

Hyderabad, Telangana, India

On-site

Preferred Skills, Education, and Experience: Any graduate Good communication skills and fair command of English language Experienced in AR Follow-up and Denials Management Good understanding of the US Healthcare revenue cycle and its intricacies Excellent analytical and comprehension skills Roles and Responsibilities: Review providers claims that have not been paid by the insurance companies Follow-up with Insurance companies to understand the status of the claim - Initiate telephone calls or verify through payer websites or otherwise request the required information from insurance companies. Contact insurance companies for further explanation of denials and underpayments and where needed, prepare appeal packets for submission to payers Based on the responses/ findings, make the necessary corrections to the claim and re-submit/ refile as the case may be Document actions are taken into claims billing system Meet the established performance standards daily Improve skills on CPT codes and DX Codes. Make collections with a convincing approach.

Posted 3 days ago

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0.0 - 3.0 years

3 - 15 Lacs

Bengaluru, Karnataka, India

On-site

Preferred Skills, Education, and Experience: Any graduate Good communication skills and fair command of English language Experienced in AR Follow-up and Denials Management Good understanding of the US Healthcare revenue cycle and its intricacies Excellent analytical and comprehension skills Roles and Responsibilities: Review providers claims that have not been paid by the insurance companies Follow-up with Insurance companies to understand the status of the claim - Initiate telephone calls or verify through payer websites or otherwise request the required information from insurance companies. Contact insurance companies for further explanation of denials and underpayments and where needed, prepare appeal packets for submission to payers Based on the responses/ findings, make the necessary corrections to the claim and re-submit/ refile as the case may be Document actions are taken into claims billing system Meet the established performance standards daily Improve skills on CPT codes and DX Codes. Make collections with a convincing approach.

Posted 3 days ago

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1.0 - 5.0 years

0 Lacs

pune, maharashtra

On-site

The ideal candidate for this position should have experience working as a Team Leader or Designated Team Leader for at least a year. Additionally, they should possess a minimum of 5+ years of experience in Adjudication, Adjustments, or Provider Maintenance within the US Healthcare industry. The candidate must be open to working in any shift provided and should have a strong understanding of US Healthcare practices. It is essential for the candidate to have a comprehensive knowledge of CPT Codes, Diagnosis Codes, and the Authorization Process. They should also be familiar with the pre-adjudication and post-adjudication processes of the Claim Life Cycle. Proficiency in English comprehension is required, along with the ability to work independently and communicate effectively with various stakeholders. The candidate should be willing to adapt to different shift timings and should be capable of conducting sessions and providing On-the-Job Training support. In terms of responsibilities, the selected candidate will be required to assist team members with their queries and take ownership of their targets and goals. They will be responsible for managing a team of 10-15 associates and ensuring adherence to norms related to attendance, punctuality, reporting, and completion of work.,

Posted 1 week ago

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2.0 - 9.0 years

0 Lacs

hyderabad, telangana

On-site

You should have good knowledge and experience in E/M OP, including handling different specialties such as orthopaedics and dermatology. Your expertise should extend to 1 to 6 & 9 series, proficiency in ICD and CPT codes, strong familiarity with medical terminology, human anatomy, and physiology. It is essential to provide feedback, identify error patterns, and possess good knowledge of modifiers. You will be responsible for maintaining daily production and quality as per client requirements. A minimum of two years of experience in Quality is required, with excellent communication and teamwork skills. This is a work from office position, and you must have at least two years of experience as QA/SME on paper. The preferred candidate should have 4 to 9 years of experience with certification from AAPC or AHIMA (CPC, COC, CIC, CCS).,

Posted 1 week ago

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2.0 - 7.0 years

1 - 4 Lacs

Karnataka

Work from Office

Assign codes to diagnoses and procedures, using ICD and CPT codes - Ensure codes are accurate and sequenced correctly in accordance with Government and Insurance regulations - Follow up with the provider on any documentation that is insufficient or unclear - Communicate with other clinical staff regarding documentation - Search for information in cases where the coding is complex or unusual - Receive and review patient charts and documents for accuracy - Review the previous day's batch of patient notes for evaluation and coding - Ensure that all codes are current and active Skills/Experience : - Bachelor's degree in Life Sciences, Pharmacy, Biotechnology, Nursing - Strong knowledge of Anatomy, Physiology and, Medical terminology - 2-4 Years- experience in Medical Coding - Certification is preferred - Fluent verbal communication abilities - Knowledge of Healthcare terminology and ICD/CPT codes - Strong reporting skills - Familiar with Microsoft Excel - Excellent typing and accuracy.

Posted 1 week ago

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2.0 - 6.0 years

0 Lacs

haryana

On-site

You are invited to join as an AR Caller or Sr. AR Caller specializing in US Healthcare at our office located in Gurgaon on MG Road. With 2 to 4 years of experience in Revenue Cycle Management within the US Medical Billing sector, you will play a vital role in communicating with insurance companies in the USA to manage outstanding accounts receivables on behalf of doctors and physicians. Your responsibilities will include demonstrating a strong grasp of HIPPA regulations, CPT codes, ICD9/10, Appeals, and denial management. The ideal candidate for this position should possess a minimum of 2 years of experience as an AR Caller, along with exposure to denial management processes. To excel in this role, you must have excellent English communication skills, both verbal and written. Additionally, proficiency in computer usage, strong interpersonal skills, the ability to work well under pressure, quick decision-making skills, and a willingness to learn are essential traits we are looking for. Eligible candidates should be at least 18 years old, hold a graduate degree, have fluent English communication skills, be comfortable with night shifts, and able to work from the office. Immediate joining is required, and the role offers excellent growth opportunities with fixed US night shifts and a 5-day workweek, ensuring a good work-life balance with weekends off. If you meet these requirements and are looking to be a part of a dynamic team in the US Healthcare sector, we encourage you to apply and explore this exciting opportunity with us.,

Posted 1 week ago

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0.0 - 4.0 years

0 Lacs

hisar, haryana

On-site

You are a fresher who will be gaining experience in Health Claims by undergoing a few days of training. Your main responsibility will be to accurately process and adjudicate medical claims in compliance with company policies, industry regulations, and contractual agreements. In this role, you will review and analyze medical claims submitted by healthcare providers to ensure accuracy, completeness, and adherence to insurance policies and regulatory requirements. You will also verify patient eligibility, insurance coverage, and benefits to determine claim validity and appropriate reimbursement. Assigning appropriate medical codes such as ICD-10 and CPT to diagnoses, procedures, and services according to industry standards will be a crucial part of your job. Additionally, you will adjudicate claims based on established criteria like medical necessity and coverage limitations to ensure fair and accurate reimbursement. It will be your responsibility to process claims promptly and accurately using designated platforms. You will investigate and resolve discrepancies, coding errors, and claims denials through effective communication with healthcare providers, insurers, and internal teams. Collaboration with billing, audit, and other staff to address complex claims issues and ensure proper documentation and justification for claim adjudication will be essential. To excel in this role, you should maintain up-to-date knowledge of healthcare regulations, coding guidelines, and industry trends to ensure compliance and best practices in claims processing. Providing courteous and professional customer service to policyholders, healthcare providers, and other stakeholders regarding claim status, inquiries, and appeals is also expected. Documenting all claims processing activities, decisions, and communications accurately and comprehensively in designated systems or databases is a key part of the job. Participation in training programs, team meetings, and quality improvement initiatives to enhance skills, productivity, and overall performance is encouraged. Ideally, you should have a Masters/Bachelors degree in Nursing, B.Pharma, M.Pharma, BPT, MPT, or a related field. Excellent analytical skills with attention to detail, accuracy in data entry, and claims adjudication are essential. Effective communication and interpersonal skills, the ability to collaborate across multidisciplinary teams, and interact professionally with external stakeholders are required. You should possess a problem-solving mindset with the ability to identify issues, propose solutions, and escalate complex problems as needed. A commitment to continuous learning and professional development in the field of healthcare claims processing is crucial for success in this role.,

Posted 1 week ago

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2.0 - 7.0 years

1 - 4 Lacs

Kochi

Work from Office

Designation : Medical Coder Full Time Opportunity Job Description : Assign codes to diagnoses and procedures, using ICD and CPT codes - Ensure codes are accurate and sequenced correctly in accordance with Government and Insurance regulations - Follow up with the provider on any documentation that is insufficient or unclear - Communicate with other clinical staff regarding documentation - Search for information in cases where the coding is complex or unusual - Receive and review patient charts and documents for accuracy - Review the previous day's batch of patient notes for evaluation and coding - Ensure that all codes are current and active Skills/Experience : - Bachelor's degree in Life Sciences, Pharmacy, Biotechnology, Nursing - Strong knowledge of Anatomy, Physiology and, Medical terminology - 2-4 Years- experience in Medical Coding - Certification is preferred - Fluent verbal communication abilities - Knowledge of Healthcare terminology and ICD/CPT codes - Strong reporting skills - Familiar with Microsoft Excel - Excellent typing and accuracy

Posted 1 week ago

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0.0 - 5.0 years

3 - 5 Lacs

Noida

Work from Office

Contact insurance companies in the US to follow up on unpaid or denied medical claims Review patient account information resolve denials or rejections Work on hospital billing claims Analyze denial codes, understand reason for denials Required Candidate profile Document update the system with call outcomes and next steps Ensure adherence to HIPAA guidelines internal quality std Meet daily and weekly targets for call volume resolution Communicate effectively Perks and benefits Perks and Benefits

Posted 2 weeks ago

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2.0 - 6.0 years

0 Lacs

haryana

On-site

You are invited to join our team as an AR Caller or Senior AR Caller in the US Healthcare sector, based in Gurgaon at MG Road with the requirement to work from the office. With a minimum of 2 to 4 years of experience in the field, candidates with an Accounting/Finance background are advised not to apply for this position. Your role will involve a comprehensive understanding of Revenue Cycle Management in US Medical Billing for Providers/Hospitals. Key responsibilities include interacting with insurance companies in the USA on behalf of healthcare professionals to follow up on outstanding accounts receivables. Additionally, you should have a strong grasp of HIPPA, CPT codes, ICD9/10, Appeals, denial management, and exposure in denial management. To excel in this role, excellent English communication skills, both verbal and written, are essential. Additionally, proficiency in computer skills, along with the ability to work under pressure, quick learning capabilities, and strong decision-making skills are required. Interpersonal skills are also crucial for successful interaction with various stakeholders. Eligibility criteria for this position include being above 18 years of age, a graduate with fluent English communication abilities, comfortable with night shifts, and willing to work from the office. Immediate joining is preferred. In return, we offer the opportunity to work in US shift timings with fixed shifts and weekends off, providing an excellent growth trajectory for motivated candidates.,

Posted 2 weeks ago

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0.0 - 4.0 years

0 Lacs

chennai, tamil nadu

On-site

About R1 R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work For 2023 by Great Place To Work Institute. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare simpler and enable efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 14,000 strong in India with offices in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities Roles & Responsibilities: Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Should have sound knowledge of working on Billing scrubbers and making edits. Work on Contractual adjustments & write off projects. Should have good Cash collected/Resolution Rate. Should have calling skills, probing skills and denials understanding. Work in all shifts on a rotational basis. No Planned leaves for next 6 months Requirements: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal). Skill Set: Candidate should be good in Denial Management. Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials. Ability to interact positively with team members, peer group and seniors. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package.,

Posted 3 weeks ago

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2.0 - 7.0 years

1 - 4 Lacs

Kerala

Work from Office

Assign codes to diagnoses and procedures, using ICD and CPT codes - Ensure codes are accurate and sequenced correctly in accordance with Government and Insurance regulations - Follow up with the provider on any documentation that is insufficient or unclear - Communicate with other clinical staff regarding documentation - Search for information in cases where the coding is complex or unusual - Receive and review patient charts and documents for accuracy - Review the previous day's batch of patient notes for evaluation and coding - Ensure that all codes are current and active Skills/Experience : - Bachelor's degree in Life Sciences, Pharmacy, Biotechnology, Nursing - Strong knowledge of Anatomy, Physiology and, Medical terminology - 2-4 Years- experience in Medical Coding - Certification is preferred - Fluent verbal communication abilities - Knowledge of Healthcare terminology and ICD/CPT codes - Strong reporting skills - Familiar with Microsoft Excel - Excellent typing and accuracy

Posted 3 weeks ago

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1.0 - 6.0 years

1 - 3 Lacs

Chennai

Work from Office

Dear Aspirants, Warm Greetings!! We are hiring for the following details, Position: - AR Analyst - Charge Entry & Charge QC - Payment Posting Salary: Based on Performance & Experienced Exp : Min 1 year Required Joining: Immediate Joiner / Maximum 10 days NB: Freshers do not apply Work from office only (Direct Walkins Only) Monday to Friday ( 11 am to 5 Pm ) Everyday Contact person Nausheen HR( 9043004655) Interview time (11Am to 5 Pm) Bring 2 updated resumes Refer( HR Name - Nausheen Begum HR) Mail Id : nausheen@novigoservices.com Call / Whatsapp (9043004655) Refer HR Nausheen Location : Chennai , Ekkattuthangal Warm Regards, HR Recruiter Nausheen HR Novigo Integrated Services Pvt Ltd, Sai Sadhan,1st Floor, TS # 125, North Phase,SIDCOIndustrial Estate, Ekkattuthangal, Chennai 32 Contact details:- HR Nausheen nausheen@novigoservices.com Call / Whatsapp ( 9043004655)

Posted 1 month ago

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2.0 - 7.0 years

2 - 4 Lacs

Kolkata

Work from Office

Assign codes to diagnoses and procedures, using ICD and CPT codes - Ensure codes are accurate and sequenced correctly in accordance with Government and Insurance regulations - Follow up with the provider on any documentation that is insufficient or unclear - Communicate with other clinical staff regarding documentation - Search for information in cases where the coding is complex or unusual - Receive and review patient charts and documents for accuracy - Review the previous day's batch of patient notes for evaluation and coding - Ensure that all codes are current and active Skills/Experience : - Bachelor's degree in Life Sciences, Pharmacy, Biotechnology, Nursing - Strong knowledge of Anatomy, Physiology and, Medical terminology - 2-4 Years- experience in Medical Coding - Certification is preferred - Fluent verbal communication abilities - Knowledge of Healthcare terminology and ICD/CPT codes - Strong reporting skills - Familiar with Microsoft Excel - Excellent typing and accuracy

Posted 1 month ago

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2.0 - 7.0 years

2 - 4 Lacs

Kanpur

Work from Office

Assign codes to diagnoses and procedures, using ICD and CPT codes - Ensure codes are accurate and sequenced correctly in accordance with Government and Insurance regulations - Follow up with the provider on any documentation that is insufficient or unclear - Communicate with other clinical staff regarding documentation - Search for information in cases where the coding is complex or unusual - Receive and review patient charts and documents for accuracy - Review the previous day's batch of patient notes for evaluation and coding - Ensure that all codes are current and active Skills/Experience : - Bachelor's degree in Life Sciences, Pharmacy, Biotechnology, Nursing - Strong knowledge of Anatomy, Physiology and, Medical terminology - 2-4 Years- experience in Medical Coding - Certification is preferred - Fluent verbal communication abilities - Knowledge of Healthcare terminology and ICD/CPT codes - Strong reporting skills - Familiar with Microsoft Excel - Excellent typing and accuracy

Posted 1 month ago

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2.0 - 7.0 years

2 - 4 Lacs

Ahmedabad

Work from Office

Assign codes to diagnoses and procedures, using ICD and CPT codes - Ensure codes are accurate and sequenced correctly in accordance with Government and Insurance regulations - Follow up with the provider on any documentation that is insufficient or unclear - Communicate with other clinical staff regarding documentation - Search for information in cases where the coding is complex or unusual - Receive and review patient charts and documents for accuracy - Review the previous day's batch of patient notes for evaluation and coding - Ensure that all codes are current and active Skills/Experience : - Bachelor's degree in Life Sciences, Pharmacy, Biotechnology, Nursing - Strong knowledge of Anatomy, Physiology and, Medical terminology - 2-4 Years- experience in Medical Coding - Certification is preferred - Fluent verbal communication abilities - Knowledge of Healthcare terminology and ICD/CPT codes - Strong reporting skills - Familiar with Microsoft Excel - Excellent typing and accuracy

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2.0 - 7.0 years

2 - 4 Lacs

Mumbai

Work from Office

Assign codes to diagnoses and procedures, using ICD and CPT codes - Ensure codes are accurate and sequenced correctly in accordance with Government and Insurance regulations - Follow up with the provider on any documentation that is insufficient or unclear - Communicate with other clinical staff regarding documentation - Search for information in cases where the coding is complex or unusual - Receive and review patient charts and documents for accuracy - Review the previous day's batch of patient notes for evaluation and coding - Ensure that all codes are current and active Skills/Experience : - Bachelor's degree in Life Sciences, Pharmacy, Biotechnology, Nursing - Strong knowledge of Anatomy, Physiology and, Medical terminology - 2-4 Years- experience in Medical Coding - Certification is preferred - Fluent verbal communication abilities - Knowledge of Healthcare terminology and ICD/CPT codes - Strong reporting skills - Familiar with Microsoft Excel - Excellent typing and accuracy

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1.0 - 6.0 years

3 - 5 Lacs

Chennai

Work from Office

Responsibilities: Accurately code physician practitioner services through review of medical record documentation and encounter forms. Assign CPT procedure codes, ICD-10 diagnosis codes, and modifiers based on documentation, government teaching physician documentation requirements and LCD/NCD/NCCI policies. Working knowledge of E/M (Inpatient & Outpatient setting), CPT coding - Medicare 1995/1997 Documentation Guidelines. Convert document into numeric format \ Enter Logs Should be aware of entire (All range of E/M codes) Should have knowledge of minor CPT codes along E/M section with E/M Should know to handle trauma charts as well. Should be aware of all E/M modifiers. Excellence in ICD10-CM and CPT coding principles and guidelines. Knowledge of medical terminology, abbreviations, techniques, and surgical procedures; anatomy and physiology; major disease processes; pharmacology . Desired Candidate Profile: Graduation, life science background preferably Biochemistry, Microbiology, Physiotherapist, Pharmacy and Nursing. Minimum of 1 years of experience in EM IP/OP Coding Should be CCS certified from AHIMA or CPC certified Strong anatomy & physiology knowledge Interested candidate can share your resume on whatsapp 8448999197/8448999198 Act Fast!!! Regards, HR Team

Posted 2 months ago

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1.0 - 6.0 years

3 - 5 Lacs

Hyderabad, Bengaluru

Work from Office

Review and analyze insurance claims for accurate submission. Follow up with insurance companies via phone calls Resolve denied or unpaid claims Document call details Understand and interpret EOBs, denial codes, and claim adjustments. Required Candidate profile Excellent spoken English Knowledge of medical billing terminology (CPT, ICD-10, modifiers). Familiarity with US healthcare RCM cycle. Strong understanding of denial management and claim reprocessing. Perks and benefits Perks and Benefits

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2 - 6 years

2 - 6 Lacs

Gurugram

Work from Office

Essential Duties and Responsibilities: Must be on current role of team handling for minimum 1.5 years Great knowledge AR/Credit up or end-to-end knowledge Should be aware of all type of payers. Must have good understanding of payer portal for benefits & denials. Should have great verbal and written communication skills, probing skills and denials understanding Open for night shift and WFO No Planned leaves for next 6 months. Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) . Skill Set: Candidate should be good Healthcare knowledge. Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials. Ability to interact positively with team members, peer group, seniors and onshore counterpart.

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1 - 6 years

3 - 8 Lacs

Chennai

Work from Office

Role- Medical Coder: We are looking to hire an experienced Coder / Sr. Coder with active coding certifications (CPC / CPC-A / CIC / CCS / COC). With strong domain expertise in CPT and ICD (diagnosis) coding, the incumbent should be able to validate the coding after reviewing all relevant medical records ensuring codes are accurate and sequenced correctly in accordance with government and insurance regulations. Working in an evolving healthcare setting, delivering innovative solutions using our shared expertise. Using opportunities to learn and grow through rewarding interactions, collaboration, and the freedom to explore professional interests. Giving priority always to what is best for our clients, patients, and each other. With our proven and scalable operating model, complementing a healthcare organizations infrastructure to quickly drive sustainable improvements to net patient revenue and cash flows while reducing operating costs and enhancing the patient experience. Responsibilities: Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) codes. Follow up with the provider on any documentation that is insufficient or unclear. Communicate with other clinical staff regarding documentation. Search for information in cases where the coding is complex or unusual. Receive and review patient charts and documents for accuracy. Review the previous day's batch of patient notes for evaluation and coding. Ensure that all codes are current and active. Requirements: Education Any Graduate. 1 to 7 Years experience in Medical Coding. Successful completion of a certification program from AHIMA or AAPC. Strong knowledge of anatomy, physiology, and medical terminology. Skilled in assigning ICD-10 & CPT codes. Solid oral and written communication skills. Able to work independently. Flexible to work from office and home as required by the business.

Posted 2 months ago

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