Pre-Certification Representative Med-Metrix

2.0 - 4.0 years

0 Lacs

chennai, tamil nadu, india

On-site

Job Purpose The Pre-Certification Representative is responsible for obtaining and providing accurate and complete data input for precertification/preauthorization from insurance companies. Duties And Responsibilities Works effectively with insurance companies to obtain pre-certification for services Places calls to various health plans to obtain appropriate precertification prior to the patient`s appointment Ability to understand/interpret documented clinical information and relay pertinent medical/clinical information to the insurance company Faxes to pre-certification request form to insurance company Maintains files and security of confidential information utilizing host system to scan an...

Posted 5 days ago

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Team Leader - Operations (Claims) MDI NetworX

1.0 - 5.0 years

0 Lacs

pune, maharashtra

On-site

Role Overview: You have to lead a team and ensure smooth operations in the healthcare sector. Your primary responsibilities will include assisting team members, managing a team, and ensuring adherence to norms. Key Responsibilities: - Assist team members with queries and take ownership of their targets & goals - Manage a team of 10-15 associates - Ensure adherence to attendance, punctuality, reporting, and completion of work Qualification Required: - Minimum 1 year of experience as a Team Leader / Designated Team Leader - At least 5+ years of experience in Adjudication / Adjustments / Provider Maintenance - Strong knowledge of US Healthcare - Sound knowledge of CPT Codes/Diagnosis Codes - Fa...

Posted 1 month ago

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Team Leader - Operations (Claims) MDI NetworX

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...

Posted 3 months ago

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