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1.0 - 6.0 years
3 - 8 Lacs
Hyderabad, Bengaluru
Work from Office
About R1RCM R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better. R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 16,000+ strong in India with presence 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. About the role Review patient medical records following PHI, HIPPA and convert into medical coding code as per ICD-10-CM and PCS guidelines. Complete daily assign tasks within time with expected quality, on time communication to internal/external stakeholders and adhere to organization policies. We are looking to hire an experienced Medical Coders / Senior Medical Coders with coding certifications (CIC or CCS) hands on experience on Inpatient DRG (MS-DRG/APR-DRG) coding. Eligibility Criteria 1 to 7+ Years of work experience in IP DRG medical Coding Education Any Graduate, Postgraduate Successful completion of a certification program from AHIMA (CCS) or AAPC (CIC) Must be active during joining and verified. Strong knowledge of anatomy, physiology, and medical terminology Effective verbal and written communication skills (should have capability to reply to email properly to client and stakeholders) Able to work independently and willing to adapt and change as per business/process requirement. Responsibilities Reviewed inpatient medical records and assigned accurate ICD-10-CM (PDx and SDx) and PCS codes for diagnoses and procedures. Assigned and sequenced codes accurately based on medical record documentation. Assigned POA indicators correctly. Thorough understanding and application of medical necessity, DRGs, APGs, and APRs for processing claims Adhered to coding clinics and guidelines, and queried physicians for clarification as needed. Checking on the account status on regular basis if kept on Hold and follow up with respective leaders when in needed. Knowledge of 3M coding, Optum, computer assisted coding (CAC), abstracting software, Meditech etc. will be added advantage. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
4.0 - 7.0 years
3 - 7 Lacs
Hyderabad
Work from Office
Medical Coding Certified Fresher Certifications (CPC/CPC-A/CCS/ COC) About R1RCM R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better. R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, recognized as one of Indias Top 50 Best Workplaces for Women 2024, amongst Indias Top 25 Best Workplaces in Diversity, Equity, Inclusion & Belonging 2024, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 17,000+ strong in India with presence in Delhi NCR, Hyderabad, Bengaluru, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Responsibilities:Assign codes to diagnoses and procedures, using ICD (International Classification of Diseases) and CPT (Current Procedural Terminology) 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.:Education Any Graduate.Successful completion of a certification program from AHIMA or AAPC.Strong knowledge of anatomy, physiology, and medical terminology.Familiarity with ICD-10 & CPT codes and procedures.Solid oral and written communication skills.Able to work independently. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
2.0 - 5.0 years
5 - 9 Lacs
Gurugram
Work from Office
R1 RCM India is proud to be a Great Place To Work Certified organization. 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 . Designation Lead Associate Reports to (level of category) Individual COA(Performance Management) Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash-posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Analysis data to identify process gaps, prepare reports and share findings for Metrics improvement. Able to interact independently with counterparts. Project Management Performance management First level of escalation and able to end to end closure of highlighted issues Work in all shifts on a rotational basis WFO only Need to be cost efficient with regards to processes, resource utilization and overall constant cost management Must operate utilizing aggressive operating metrics. Qualifications Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MBA, MCA B.Tech Freshers') 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. Subject matter expert in AR follow up Good knowledge of SQL/PowerBI/Excel Demonstrated ability to exceed performance targets Ability to effectively prioritize individual and team responsibilities Communicates well in front of groups, both large and small. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
1.0 - 6.0 years
1 - 5 Lacs
Chennai
Work from Office
About US: R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better. R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, recognized as one of Indias Top 50 Best Workplaces for Women 2024, amongst Indias Top 25 Best Workplaces in Diversity, Equity, Inclusion & Belonging 2024, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 17,000+ strong in India with presence in Delhi NCR, Hyderabad, Bengaluru, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. 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. : 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. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
1.0 - 3.0 years
13 - 18 Lacs
Gurugram
Work from Office
R1 RCM is a leading provider of revenue cycle services and physician advisory services to healthcare providers. We help transform and manage the commercial infrastructure of care organizations. About the role Needs to work closely and communicate effectively with internal and external stakeholders in an ever-changing, rapid growth environment with tight deadlines. This role involves designing and analyzing the healthcare reimbursement model . Be able take up new initiatives, maintain synchrony in the team. Collaborate with external & internal stakeholders, work effectively in a growing team, be a strong team player. Be able to create and define SOPs, TATs for ongoing and upcoming projects. What you will do To design, analyze and maintain healthcare reimbursement models to ensure the revenue estimation is in-line with the contracts. To perform various analytical reviews and deep-dives (root cause analysis) on clie nt-specific healthcare reimbursement methodology to ensure accuracy of revenue projections and actual collections. To report/highlight the exceptions in reimbursement method by building contract models for Hospital charges To effectively communicate the findings/ observations with recommended action to US team/clients. Maintain MIS related to analysis , Accuracy and coverage report for maintenance databases Handling client calls and communicating effectively for task deliverables and site maintenance What will you need Graduate degree Preferabl y in Statistics\ Mathematics \ Economics\ Commerce\Finance from a reputed educational institute Good analytical and algorithm building skills , having experience to build contract models for hospital charges to calculate expected reimbursement Skills to read, understand and interpret reimbursement contracts between hospitals and insurance providers. Experience/knowledge of various US healthcare reimbursement methods like MS DRG weightage, Multipliers, % of charges, outliers, Grouper fee schedule etc. Good Communication Skills (both written & verbal) Preferable - 1-3 years of experience in US healthcare Having good knowledge about RCM cycle and denial management 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
2.0 - 5.0 years
5 - 9 Lacs
Gurugram
Work from Office
R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better. R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, amongst Top 50 Best Workplaces for Millennials, Top 50 for Women, Top 25 for Diversity and Inclusion and Top 10 for Health and Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 17,000+ strong in India with presence 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. Designation Lead Associate Reports to (level of category) Individual COA(Performance Management) Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash-posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Analysis data to identify process gaps, prepare reports and share findings for Metrics improvement. Able to interact independently with counterparts. Project Management Performance management First level of escalation and able to end to end closure of highlighted issues Work in all shifts on a rotational basis WFO only Need to be cost efficient with regards to processes, resource utilization and overall constant cost management Must operate utilizing aggressive operating metrics. Qualifications Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MBA, MCA B.Tech Freshers') 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. Subject matter expert in AR follow up Good knowledge of SQL/PowerBI/Excel Demonstrated ability to exceed performance targets Ability to effectively prioritize individual and team responsibilities Communicates well in front of groups, both large and small. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
1.0 - 6.0 years
2 - 6 Lacs
Hyderabad
Work from Office
About US: R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better. R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, recognized as one of Indias Top 50 Best Workplaces for Women 2024, amongst Indias Top 25 Best Workplaces in Diversity, Equity, Inclusion & Belonging 2024, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 17,000+ strong in India with presence in Delhi NCR, Hyderabad, Bengaluru, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. 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. : 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. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
1.0 - 6.0 years
3 - 7 Lacs
Noida, Hyderabad, Chennai
Work from Office
About the roleReview patient medical records following PHI, HIPPA and convert into medical coding code as per ICD-10-CM and PCS guidelines. Complete daily assign tasks within time with expected quality, on time communication to internal/external stakeholders and adhere to organization policies.We are looking to hire an experienced Medical Coders / Senior Medical Coders with coding certifications (CIC or CCS) hand on experience on Inpatient DRG (MS-DRG/APR-DRG) coding.Responsibilities:Reviewed inpatient medical records and assigned accurate ICD-10-CM (PDx and SDx) and PCS codes for diagnoses and procedures. Assigned and sequenced codes accurately based on medical record documentation. Assigned POA indicators correctly.Thorough understanding and application of medical necessity, DRGs, APGs, and APRs for processing claimsAdhered to coding clinics and guidelines, and queried physicians for clarification as needed.Checking on the account status on regular basis if kept on Hold and follow up with respective leaders when in needed.Knowledge of 3M coding, Optum, computer assisted coding (CAC), abstracting software, Meditech etc. will be added advantage.:1 to 7+ Years experience in IP DRG medical CodingEducation Any Graduate (preferable life Science Graduate)Successful completion of a certification program from AHIMA (CCS) or AAPC (CIC) Must be active during joining and verified.Strong knowledge of anatomy, physiology, and medical terminologyEffective verbal and written communication skills (should have capability to reply to email properly to client and stakeholders)Able to work independently and willing to adapt and change as per business/process requirement. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
2.0 - 5.0 years
5 - 9 Lacs
Gurugram
Work from Office
R1 RCM India is proud to be recognized amongst India's Top 50 Best Companies to Work For TM 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 . Designation S r. Analyst /Lead Associate Reports to (level of category) Individual COA( Performance Management) Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash - posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties and Responsibilities Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Analysis data to identify process gaps, prepare reports and share findings for Metrics improvement. Able to interact independently with counterparts. Performance management First level of escalation Work in all shifts on a rotational basis WFO only Need to be cost efficient with regards to processes, resource utilization and overall constant cost management Must operate utilizing aggressive operating metrics. Qualifications Graduate in any discipline from a recognized educational institute (Except B.Pharma , M.Pharma , Regular MBA, MCA B.Tech Freshers') 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. Subject matter expert in AR follow up Demonstrated ability to exceed performance targets Ability to effectively prioritize individual and team responsibilities Communicates well in front of groups, both large and smal l. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
1.0 - 6.0 years
3 - 7 Lacs
Hyderabad
Work from Office
About US: R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better. R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, recognized as one of Indias Top 50 Best Workplaces for Women 2024, amongst Indias Top 25 Best Workplaces in Diversity, Equity, Inclusion & Belonging 2024, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 17,000+ strong in India with presence in Delhi NCR, Hyderabad, Bengaluru, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. About the role Review patient medical records following PHI, HIPPA and convert into medical coding code as per ICD-10-CM and PCS guidelines. Complete daily assign tasks within time with expected quality, on time communication to internal/external stakeholders and adhere to organization policies. We are looking to hire an experienced Medical Coders / Senior Medical Coders with coding certifications (CIC or CCS) hands on experience on Inpatient DRG (MS-DRG/APR-DRG) coding. Eligibility Criteria 1 to 7+ Years of work experience in IP DRG medical Coding Education Any Graduate, Postgraduate Successful completion of a certification program from AHIMA (CCS) or AAPC (CIC) Must be active during joining and verified. Strong knowledge of anatomy, physiology, and medical terminology Effective verbal and written communication skills (should have capability to reply to email properly to client and stakeholders) Able to work independently and willing to adapt and change as per business/process requirement. Responsibilities Reviewed inpatient medical records and assigned accurate ICD-10-CM (PDx and SDx) and PCS codes for diagnoses and procedures. Assigned and sequenced codes accurately based on medical record documentation. Assigned POA indicators correctly. Thorough understanding and application of medical necessity, DRGs, APGs, and APRs for processing claims Adhered to coding clinics and guidelines, and queried physicians for clarification as needed. Checking on the account status on regular basis if kept on Hold and follow up with respective leaders when in needed. Knowledge of 3M coding, Optum, computer assisted coding (CAC), abstracting software, Meditech etc. will be added advantage. 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. To learn more, visitr1rcm.com Visit us on Facebook
Posted 1 month ago
0.0 - 2.0 years
2 - 4 Lacs
Hyderabad
Work from Office
We are looking for a highly motivated and enthusiastic individual to join our team as a Trainee in X-Ray at Vijaya Diagnostic Centre. The ideal candidate will have a strong foundation in healthcare and be eager to learn and grow with our organization. Roles and Responsibility Assist the senior staff in performing various medical procedures, including X-ray examinations. Maintain accurate records of patient information and procedure details. Ensure proper patient preparation and positioning for X-ray procedures. Collaborate with other departments to ensure seamless patient care. Participate in ongoing education and training to enhance skills and knowledge. Contribute to the development and implementation of new protocols and procedures. Job Requirements Strong understanding of medical terminology and imaging principles. Ability to work effectively in a fast-paced environment and prioritize tasks. Excellent communication and interpersonal skills. Basic knowledge of medical equipment and instruments. Ability to maintain confidentiality and handle sensitive information. Strong attention to detail and organizational skills. Additional Info For more information, please contact us at 9630724ea8fa4ee5 or email us at [insert email ID].
Posted 1 month ago
0.0 - 1.0 years
2 - 6 Lacs
Bengaluru
Work from Office
The Coderperforms a variety of activities involving the coding of medical records as a mechanism for indexing medical information which is used for completion of statistics for hospital, regional and government planning and accurate hospital reimbursement. Codes inpatient and/or outpatient records and identifies diagnoses and procedures daily according to the schedule set within the coding unit. The Coder accurately assigns ICD-10 and/or CPT-4 codes in accordance with Coding Departmental guidelines maintaining no less than 95% accuracy in choice and sequencing of codes. The Coder identifies and abstracts records consistently and accurately. Consistently demonstrates time awarenessstrives to meet deadlines; reduces non-essential interruptions to an absolute minimum. Meets departmental productivity standards for coding and entering inpatient and/or outpatient records. Participates in coding meetings and education conferences to maintain coding skills and accuracy. Demonstrates willingness and flexibility in working additional hours or changing hours. Demonstrates thorough understanding on how position impacts the department and hospital. Demonstrates a good rapport and works to establish cooperative working relationships with all members of departmental and Hospital staff. Attend conference calls as necessary to provide information relating to Coding Should be a Graduate Certified Fresher/ experience in medical coding or with any other previous experience. If experience in Medical Coding G23 (0 to 1 Year) Must be a certified coder through AAPC or AHIMA. Certifications accepted include CPC, CCS,CIC and COC Anyone All the candidates must have current coding certifications and must provide proof of certification with valid certification identification number during interview / Offer process.
Posted 1 month ago
0.0 - 2.0 years
3 - 7 Lacs
Pune
Work from Office
Primary Responsibilities: The Coder performs a variety of activities involving the coding of medical records as a mechanism for indexing medical information which is used for completion of statistics for hospital, regional and government planning and accurate hospital reimbursement Codes inpatient and/or outpatient records and identifies diagnoses and procedures daily according to the schedule set within the coding unit The Coder accurately assigns ICD-10 and/or CPT-4 codes in accordance with Coding Departmental guidelines maintaining no less than 95% accuracy in choice and sequencing of codes The Coder identifies and abstracts records consistently and accurately Consistently demonstrates time awarenessStrives to meet deadlines; reduces non-essential interruptions to an absolute minimum Meets departmental productivity standards for coding and entering inpatient and/or outpatient records Participates in coding meetings and education conferences to maintain coding skills and accuracy Demonstrates willingness and flexibility in working additional hours or changing hours Demonstrates thorough understanding on how position impacts the department and hospital Demonstrates a good rapport and works to establish cooperative working relationships with all members of departmental and Hospital staff Attend conference calls as necessary to provide information relating to Coding Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Full-timeYes Work from officeYes Travelling Onsite / OffsiteNo Required Qualifications: Should be a Graduate – Any Graduate Certified Fresher or Experience in medical coding or with any other previous experience Must be a certified coder through AAPC or AHIMA Certifications accepted include CPC, CCS, CIC and COC – Anyone G23 (0 to 2+ years), G24 (3+ years) If experience in Medical Coding All the candidates must have current coding certifications and must provide proof of certification with valid certification identification number during interview / Offer process At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone – of every race, gender, sexuality, age, location and income – deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission. #NTRQ External Candidate Application Internal Employee Application
Posted 1 month ago
1.0 - 3.0 years
3 - 6 Lacs
Chennai
Work from Office
We are looking for a highly skilled and experienced Medical Data Abstractor to join our team at Omega Healthcare Management Services Pvt. Ltd., located in Chennai I. The ideal candidate will have 1-3 years of experience in the field. Roles and Responsibility Accurately and efficiently abstract medical data from various sources. Maintain confidentiality and adhere to HIPAA guidelines when handling sensitive information. Collaborate with team members to achieve project goals and objectives. Develop and implement effective data abstraction processes to improve quality and productivity. Identify and resolve data discrepancies or errors promptly. Participate in ongoing training and professional development to stay current with industry trends and best practices. Job Strong knowledge of medical terminology and concepts, including anatomy, physiology, and pharmacology. Excellent analytical and problem-solving skills, with attention to detail and accuracy. Ability to work independently and as part of a team, with strong communication and interpersonal skills. Proficiency in using computer software applications, including Microsoft Office and other relevant tools. Strong organizational and time management skills, with the ability to prioritize tasks and meet deadlines. Commitment to delivering high-quality results and maintaining a focus on customer satisfaction.
Posted 1 month ago
1.0 - 5.0 years
2 - 3 Lacs
Pune
Work from Office
We are looking for a highly skilled and experienced Assistant to join our Imaging Services team at Vijaya Diagnostic Centre. The ideal candidate will have 0 to 5 years of experience in the healthcare industry. Roles and Responsibility Assist in planning and implementing imaging services, including patient preparation and explaining procedures. Operate various medical imaging equipment, such as X-ray machines and CT scanners, under the direction of senior staff. Maintain accurate records of patient information, imaging results, and treatment plans. Collaborate with other healthcare professionals to provide comprehensive care to patients. Stay updated on the latest developments in medical imaging technology and techniques. Participate in quality improvement initiatives to enhance patient care and outcomes. Job Requirements Strong understanding of medical imaging principles and practices. Ability to work effectively in a fast-paced environment with attention to detail. Excellent communication and interpersonal skills. Ability to maintain confidentiality and handle sensitive information. Basic knowledge of medical terminology and anatomy. Familiarity with hospital policies and procedures related to patient care and safety.
Posted 1 month ago
0.0 - 2.0 years
1 - 3 Lacs
Bengaluru
Work from Office
We are looking for a skilled Typist to join our team at Vijaya Diagnostic Centre in the healthcare industry. The ideal candidate will have excellent documentation skills and be able to work efficiently in a fast-paced environment. Roles and Responsibility Prepare and maintain accurate and up-to-date records and documents. Develop and implement effective filing systems, both physical and digital. Provide administrative support to ensure smooth operations. Coordinate with various departments to ensure seamless communication. Maintain confidentiality and handle sensitive information with discretion. Perform other related duties as assigned by management. Job Requirements Proficient in typing with high accuracy and speed. Excellent knowledge of Microsoft Office and other productivity software. Strong organizational and time management skills. Ability to work independently and as part of a team. Good communication and interpersonal skills. Familiarity with medical terminology and healthcare procedures is an advantage.
Posted 1 month ago
0.0 - 2.0 years
1 - 2 Lacs
Ariyalur, Kumbakonam, Tiruchirapalli
Work from Office
Medical Coding is the process of converting Verbal Descriptions into numeric or alpha numeric by using ICD 10-CM, CPT & HCPCS. As per HIPAA rules healthcare providers need efficient Medical Coders. Qualification & Specifications : MBBS, BDS, BHMS, BAMS, BSMS, PHARMACY B.Sc/M.Sc (Life Sciences / Biology / Bio Chemistry / Micro Biology / Nursing / Bio Technology), B.P.T, B.E BIOMEDIAL, B.Tech (Biotechnology/Bio Chemistry). 2020 -2024 passed out Skills Required: * Candidates should have Good Communication & Analytical Skills and should be Good at Medical Terminology (Physiology & Anatomy). Role: To review US medical records Initial file review for identifying merits Subjective review and analysis to identify instances of negligence, factors contributing to it To review surgical procedures, pre and post-surgical care, nursing home negligence To prepare medical submissions To prepare the medical malpractice case Regards Kowshika 7200652461
Posted 1 month ago
0.0 - 2.0 years
3 - 7 Lacs
Coimbatore
Work from Office
Primary Responsibilities: The Coderperforms a variety of activities involving the coding of medical records as a mechanism for indexing medical information which is used for completion of statistics for hospital, regional and government planning and accurate hospital reimbursement Codes inpatient and/or outpatient records and identifies diagnoses and procedures daily according to the schedule set within the coding unit The Coder accurately assigns ICD-10 and/or CPT-4 codes in accordance with Coding Departmental guidelines maintaining no less than 95% accuracy in choice and sequencing of codes The Coder identifies and abstracts records consistently and accurately Consistently demonstrates time awarenessstrives to meet deadlines; reduces non-essential interruptions to an absolute minimum Meets departmental productivity standards for coding and entering inpatient and/or outpatient records Participates in coding meetings and education conferences to maintain coding skills and accuracy Demonstrates willingness and flexibility in working additional hours or changing hours Demonstrates thorough understanding on how position impacts the department and hospital Demonstrates a good rapport and works to establish cooperative working relationships with all members of departmental and Hospital staff Attend conference calls as necessary to provide information relating to Coding Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications: Should be a Graduate Any Graduate Certified Fresher or experience in medical coding or with any other experience If experience in Medical Coding G23 (0 to 2+ years), G24 (3+ years) Certified coder through AAPC or AHIMA Certifications accepted include CPC, CCS,CIC and COC Anyone Current coding certifications and must provide proof of certification with valid certification identification number during interview / Offer process At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission. #NTRQ
Posted 1 month ago
10.0 - 15.0 years
6 - 11 Lacs
Hyderabad
Work from Office
Primary Responsibilities: Maintain knowledge of coding and billing requirements and regulatory changes KPIs include but not limited to Productivity, quality, TAT, Attendance and Attrition Quick turnaround using logical understanding of data Manages overall personnel, performance, and discipline of the assigned project(s) Provide expertise and leadership in assigned functional area Manage relationship with internal stakeholders and functions Manage all client interaction and client communication. Should front end the relationship with the client Review and analysis of periodic reports and metrics Evaluation of operational practices and procedures Provide support to quality initiatives targeted towards process improvements Actively involved in the internal audit support, ensuring all compliance parameters are met Establish and maintain a working environment conducive to positive morale, individual style, quality, creativity, and teamwork Provide direction to staff; ensure resolution of problems; sets priorities Actively provides inputs and assistance to the senior management in the planning, implementation, and evaluation / modifications to existing operations, systems, and procedures, specifically relating to his/her assigned project(s) Managing attrition and building retention strategies Preparation of annual business plans including operating budgets Negotiating solutions, resolving conflicts and anticipating/handling critical situations Providing regular performance feedback and giving frequent formal and informal coaching sessions Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications: Graduate or Postgraduate inLife Sciences, Allied Medicine (BHMS, BAMS, BPT, Dental Grads, Pharmacist, Nursing) or others Certified coder AAPC / AHIMA CCS/CPC/CPC-H/CCS-P 10+ years of coding experience with about 3-4 yr experience as a Team Lead Knowledge of organizational structure, workflow, and operating procedures Thorough knowledge of medical terminology, human anatomy/ physiology, pathophysiology Proficient in healthcare reimbursement methodologies Proven ability to manage and enable teams to reach their goals Proven good analytical and communication skills Proven solid interpersonal and communication skills Proven solid acumen towards employee engagements & driving customer satisfaction Proven ability to work closely with SME, Auditor and Trainer and identify training needs for outliers Proven ability to effectively provide 1 on 1 coaching Proven ability to monitor absences and overall day to day operations Proven ability to identify areas of weakness and provide educational teaching to improve those areas of weakness At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission. #njp #NTRQ
Posted 1 month ago
4.0 - 9.0 years
7 - 12 Lacs
Noida
Work from Office
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Under direct supervision, the Surgery Coder is responsible for accurate coding of the professional services (diagnoses, procedures, and modifiers) from medical records in a hospital/clinic setting. Analyzing the medical record, assigning ICD-CM, CPT, and HCPCS Level II codes with appropriate modifiers. Medical coding is performed in accordance with the rules, regulations and coding conventions of ICD-10-CM Official Guidelines for Coding and Reporting, CPT guidelines for reporting professional and surgical services, CMS updates, Coding Clinic articles published by the American Hospital Association, assigning codes from HCPCS code book for supplies and equipment, NCCI Edits, and Client Coding Guidelines. Primary Responsibilities: Verifies and abstracts all the relevant data from the medical records to assign appropriate codes for the following settingsMultispecialty Outpatient Surgery centre and hospital Ability to code 4-6 charts per hour and meeting the standards for quality criteria. Needs to constantly track and implement all the updates of AMA guidelines, AHA guidelines, and CMS guidelines Expertise in determining the correct CPT for procedures performed and appending modifiers to CPT codes as per NCCI edits and CPT guidelines Ability to check NCCI edits and LCD & NCD coverage determinations and modify ICD-10-CM codes, CPT codes, and modifiers accordingly An ideal team player who can work in a large group and provide inputs to the team for betterment of the team in terms of quality and productivity Under general supervision, organizes and prioritizes all work to ensure that records are coded and edits are resolved in a timeframe that will assure compliance with regulatory and client guidelines Adherence with confidentiality and maintains security of systems. Compliance with HIPAA policies and procedures for confidentiality of all patient records Demonstrates knowledge of security of systems and associated policies and procedures for maintaining the security of the data contained within the systems. Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications: Life Science or Allied Medicine Graduates with certification from AAPC or AHIMA 4+ years in multispecialty Surgery Hands-on experience in coding multispecialty Surgical services such as Orthopaedics Dermatology, Gastroenterology, Cardiology, Otolaryngology, ENT, Eye, OBGYN etc. Sound knowledge in Medical Terminology, Human Anatomy & Physiology Proficient in ICD-10-CM, CPT, Modifier and HCPCS guidelines At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone – of every race, gender, sexuality, age, location and income – deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission. External Candidate Application Internal Employee Application
Posted 1 month ago
0.0 - 2.0 years
3 - 7 Lacs
Chennai
Work from Office
Primary Responsibilities: Performs a variety of activities involving the coding of medical records as a mechanism for indexing medical information which is used for completion of statistics for hospital, regional and government planning and accurate hospital reimbursement Codes inpatient and/or outpatient records and identifies diagnoses and procedures daily according to the schedule set within the coding unit Accurately assigns ICD-10 and/or CPT-4 codes in accordance with Coding Departmental guidelines maintaining no less than 95% accuracy in choice and sequencing of codes Identifies and abstracts records consistently and accurately Consistently demonstrates time awarenessstrives to meet deadlines; reduces non-essential interruptions to an absolute minimum Meets departmental productivity standards for coding and entering inpatient and/or outpatient records Participates in coding meetings and education conferences to maintain coding skills and accuracy Attend conference calls as necessary to provide information relating to Coding Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications: Graduate – Any Graduate Certifications accepted include CPC, CCS, CIC and COC – Anyone All the candidates must have current coding certifications and must provide proof of certification with valid certification identification number during interview / Offer process Certified Fresher or Experience in medical coding or with any other previous experience Experience in Medical Coding G23 (0 to 2+ years), G24 ( 3 to 5 years) Must be a certified coder through AAPC or AHIMA Demonstrates thorough understanding on how position impacts the department and hospital Demonstrates willingness and flexibility in working additional hours or changing hours Demonstrates a good rapport and works to establish cooperative working relationships with all members of departmental and Hospital staff At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. #NTRQ External Candidate Application Internal Employee Application
Posted 1 month ago
0.0 - 2.0 years
2 - 2 Lacs
Chengalpattu, Cheyyar, Chennai
Work from Office
Medical Coding is the process of converting Verbal Descriptions into numeric or alpha numeric by using ICD 10-CM, CPT && HCPCS. As per HIPAA rules healthcare providers need efficient Medical Coders. Qualification & Specifications : MBBS,BDS,BHMS,BAMS,BSMS,PHARMACYB.Sc/M.Sc (Life Sciences / Biology / Bio Chemistry / Micro Biology / Nursing / Bio Technology), B.P.T, B.E BIOMEDIAL, B.Tech (Biotechnology/Bio Chemistry). 2020-2025 passed out Skills Required: * Candidates should have Good Communication & Analytical Skills and should be Good at Medical Terminology (Physiology & Anatomy). Role: To review US medical records Initial file review for identifying merits Subjective review and analysis to identify instances of negligence, factors contributing to it To review surgical procedures, pre and post-surgical care, nursing home negligence To prepare medical submissions To prepare the medical malpractice case Regards Deepika 9880650498 https://medi-code.in/
Posted 1 month ago
11.0 years
17 - 19 Lacs
Pune
Work from Office
A Day in the Life Medtronic is expanding their footprint for Diabetes Care with a center in Pune and as a Delivery Lead Billing for Patient Financial Services, India, this role is responsible for ensuring the accuracy and completeness of billing and charges within the revenue cycle. This role involves reviewing, correcting, and processing billing errors, charge discrepancies, and claims denials within Patient Financial Services. The Diabetes Operating Unit focuses on improving the lives of those within the global diabetes community. As a business, we strive to empower people with diabetes to live life on their terms by delivering innovation that truly matters and providing support in the ways they need it. Our portfolio of innovative solutions is designed to provide customers greater freedom and better health, helping them achieve better glucose control, while spending less time managing their disease. This position is an exciting opportunity to work with Medtronics Diabetes business. Medtronic has announced its intention to separate the Diabetes division to promote future growth and innovation within the business and reallocate investments and resources across Medtronic, subject to applicable information and consultation requirements. This separation provides our team with a bold opportunity to unleash our potential, enabling us to operate with greater speed and agility. As a separate entity, we anticipate leveraging increased investments to drive meaningful innovation and enhance our impact on patient care. Responsibilities may include the following and other duties may be assigned: As a Delivery Lead Billing for Patient Financial Services, the role involves the specialist to work closely with various departments to ensure accurate coding, compliance with payer requirements, and maximization of reimbursement on Patient Financial Service accounts receivable metrics. Review and analyze charge capture data for accuracy and completeness. Identify and correct charge errors and discrepancies. Collaborate with clinical and coding staff to resolve charge-related issues. Monitor and review billing processes to ensure compliance with payer guidelines. Identify billing errors and make necessary corrections to avoid claim denials. Ensure timely and accurate submission of claims to payers. Manage the resolution of denied claims by identifying root causes and correcting errors. Resubmit corrected claims to payers for reimbursement. Track and report on claim correction activities and outcomes. Ensure all billing and charge correction activities comply with relevant laws, regulations, and internal policies. Stay updated on changes in billing regulations and payer requirements. Experience with various insurance plans offered by both government and commercial insurances (i.e., PPO, HMO, EPO, POS, Medicare, Medicaid, HRA s) and coordination of healthcare benefits, including requirements for referral, authorization, and pre-determination. Required Knowledge and Experience: Bachelor s degree in business or accounting major is preferred. 10+ years experience in healthcare insurance collections, accounts receivable management, billing and claims processing, and insurance payor contracts. Advanced knowledge of insurance contracting, payor regulations, insurance benefits, coordination of benefits, managed care, and healthcare compliance, rules, and regulations. Advanced experience with reading, and understanding medical policy information, and utilizing insurance benefit and coverage information to recovery denied claims. Advanced experience with various insurance plans offered by both government and commercial insurances. Experience with medical billing and collections terminology - CPT, HCPCS, ICD-10 and NDC coding, HIPAA guidelines and healthcare compliance. This position is eligible for a short-term incentive called the Medtronic Incentive Plan (MIP).
Posted 1 month ago
1.0 - 6.0 years
3 - 8 Lacs
Coimbatore
Work from Office
In this Role you will be Responsible for: Should have experience in Radiology coding The coder reads the documentation to understand the patients diagnoses assigned. Transforming of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes Creating uniform vocabulary for describing the causes of injury, illness & death is the role of medical coders. Medical coding allows for Uniform documentation between medical facilities. The main task of a medical coders is to review clinical statements and assign standard Codes Requirements of the role include: 1 Year of experience in any Healthcare BPO - University degree or equivalent that required 3+ years of formal studies in Life science/BPT/Pharm/Nursing Good knowledge in human Anatomy/Physiology 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. Ability to work scheduled shifts from Monday-Friday 7:30 AM to 5:30 PM IST and the shift timings can be changed as per client requirements. Flexibility to accommodate overtime and work on weekend basis business requirements. It is Mandatory to return to office based on client or business requirement. Need CPC certification
Posted 1 month ago
5.0 - 10.0 years
7 - 12 Lacs
Chennai
Work from Office
Positions General Duties and Tasks: Process Insurance Claims timely and qualitatively Meet & Exceed Production, Productivity and Quality goals Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities Analyze customer queries to provide timely response that are detailed and ordered in logical sequencing Cognitive Skills include language, basic math skills, reasoning ability with excellent written and verbal communication skills Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Continuous learning to ramp up on the knowledge curve to be the SME and to be compliant with any certification as required to perform the job Be a team player and work seamlessly with other team members on meeting customer goals Developing and maintaining a solid working knowledge of the insurance industry and of all products, services and processes performed by Claims function Handle reporting duties as identified by the team manager Handle claims processing across multiple products/accounts as per the needs of the business Requirements for this role include: Both Under Graduates and Post Graduates can apply. Excellent communication (verbal and written) and customer service skills. Able to work independently; strong analytic skills. Detail-oriented; ability to organize and multi-task. Ability to make decisions. Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications. Demonstrate strong reading comprehension and writing skills. Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills. Ability to work in a team environment. Handling different Reports - IGO/NIGO and Production/Quality. To be in a position to handle training for new hires Work together with the team to come up with process improvements Strictly monitor the performance of all team members and ensure to report in case of any defaulters. Encourage the team to exceed their assigned targets. Candidate should be flexible & support team during crisis period Should be confident, highly committed and result oriented Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home. Preferences for this role include: 5+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT. 2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts. ***Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend s basis business requirement.
Posted 1 month ago
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