COE Lead - US Healthcare Payer People Impact

25.0 - 30.0 years

90 - 150 Lacs

Hyderabad, Chennai

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25+ years in healthcare payer leadership. Expertise in claims, value-based models, risk adjustment, and member engagement. Deep knowledge of CMS, HIPAA, ACA regulations. Experience with payer tech systems (claims, analytics, CRM).

Posted 4 months ago

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Clinical Policy Review Analyst | MNC | Hyderabad | WFO | V3 Staffing

3.0 - 8.0 years

7 - 7 Lacs

hyderabad

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Greetings of the day ! Our reputed MNC Client is hiring for Clinical Policy Review Analyst role: Job Description: As a Clinical Policy Review Analyst, you will be responsible for providing in-depth clinical coding analysis of professional and facility claims, maintaining up-to-date clinical guidelines, and ensuring compliance with industry standards. Key Responsibilities: - Provide clinical coding analysis of professional and facility claims routed to the Clinical Policy Review queue - Maintain current industry knowledge of claim edit references, including AMA, CMS, NCCI, and other relevant guidelines - Conduct research on coding scenarios and provide data-driven insights and business recomm...

Posted Date not available

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