Posted:17 hours ago| Platform: Linkedin logo

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Work Mode

Remote

Job Type

Full Time

Job Description

Position Title, Responsibility Level:

Executive/Senior Executive

Function:

Operations

Reports to -

Assistant Manager/Lead Assistant Manager

Permanent/ Temporary: Permanent

Span of Control –

None

Location:

C – 15, Noida

Basic Function

This position is responsible for reviewing, analyzing and interpreting medical Information to assess and determine appropriate next action steps which may lead to denial or payment of claims.Work is performed under general supervision according to established guidelines. This individual promotes capabilities from a customer perspective, aligning needs with the target offering by creating a customer self-service enabled platform for core customers.

Essential Functions

  • Responsible for reviewing and analyzing discrepancies by cross-verifying from different data sources
  • Familiar with US Healthcare domain knowledge and understanding of healthcare regulations (HIPAA)
  • Deep understanding of medical coding, billing, and medical terminologies
  • Attention for detail, and Strong analytical skills for processing medical documentation
  • Critical thinking and high independent decision making capability
  • Proficiency in healthcare information systems
  • Ability to navigate through multiple applications
  • Operates with urgency in a real time service environment
  • Meets individual goals while assisting team to meet team goals
  • Defines, communicates and manages workflow and data coordination to support various implementation related reports (i.e., reporting, inventory, capacity reporting, and ad-hoc reports as needed by management)
  • May perform other duties as assigned

Performance parameters

  • Productivity
  • Quality
  • Turn Around Time of work assigned
  • Attendance & Schedule Adherence

Primary Internal Interactions

  • SME/AM/LAM/Manager for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking support
  • AM/LAM for the purpose of settling issues left unresolved by the SME and monthly evaluation of performance
  • SME for the purpose of handling process related issues; queries and escalated transactions
  • QCA for the purpose of associate performance feedback and audit in order to update the training curriculum
  • Mentors for the purpose of seeking clarifications and answering queries real time

Organizational Relationships

Reports To: Assistant Manager/Lead Assistant Manager

Skills

Desirable Skills

  • Critical thinking and high independent decision making
  • Strong analytical, Reasoning, and Problem solving skills
  • Medium competency in excel skills
  • Ability to comprehend and write in English for structured written communications. Emails/IMS to be sent to internal teams
  • Ability to respond to all inquiries within a timely manner
  • Strong interpersonal and communication skills – both verbal and written
  • Adaptability/Ability to interpret variable input details

Technical Skills

  • Good computer navigation skills
  • Typing speed of 25 Words per Minute with 90% Accuracy
  • Proficiency in healthcare information systems
  • Ability to navigate through multiple applications

Process Specific Skills

  • Familiar with US Healthcare domain knowledge and understanding of healthcare regulations (HIPAA)
  • Deep understanding of medical coding, billing, and medical terminologies
  • Ability to produce high quality in production in environment.
  • Ability to troubleshoot, identify user errors vs. system mapping errors (enrollment dates, method, system logic)

Soft Skills

  • Ability to work independently
  • Ability to understand and question established process guidelines for possible process improvements
  • Attention for detail, and Strong analytical skills for processing medical documentation
  • Possess keen sense of acquiring knowledge
  • Adaptable and flexible to work in night shifts

Education Requirements And Work Experience

  • Bachelor’s degree in relevant field such as Biology, Biochemistry, Biotechnology, physiotherapy etc
  • Computer literacy
  • Candidates with relevant business experience will be preferred

Annexure

Acknowledgement

(acknowledge that the information contained in this document is factual and complete)________________Candidate Supervisor DateJob DetailsRole Level: Entry-Level Work Type: Full-Time Country: India City: Noida ,Uttar Pradesh Company Website: http://www.exlservice.com Job Function: Sales Company Industry/Sector: Banking and Financial ServicesWhat We Offer

About The Company

Searching, interviewing and hiring are all part of the professional life. The TALENTMATE Portal idea is to fill and help professionals doing one of them by bringing together the requisites under One Roof. Whether you're hunting for your Next Job Opportunity or Looking for Potential Employers, we're here to lend you a Helping Hand.ReportSimilar JobsVice President Of Business Development - Public SectorInfomineoKlantenservice Medewerkerker KPN SalesContinuum Global SolutionsOperations Manager - Facilities Management Soft ServicesTransguard GroupBusiness Application SupportMMCYSales Development RepresentativeRemote Growth PartnersDisclaimer: talentmate.com is only a platform to bring jobseekers & employers together. Applicants are advised to research the bonafides of the prospective employer independently. We do NOT endorse any requests for money payments and strictly advice against sharing personal or bank related information. We also recommend you visit Security Advice for more information. If you suspect any fraud or malpractice, email us at abuse@talentmate.com.

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