5.0 - 9.0 years

0 Lacs

hyderabad, telangana

On-site

Role Overview: You will be responsible for reviewing provider disputes related to DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review. Your main tasks will include analyzing disputes, providing explanations based on findings, managing claim dispute volume, and ensuring adherence to client turnaround times and department procedures. Additionally, you will serve as a subject matter expert for the Expert Claim Review Team, creating educational materials, conducting research, and maintaining bill review content. Key Responsibilities: - Review provider disputes for DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review - Submit explanat...

Posted 4 days ago

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Inpatient DRG Sr Reviewer Zelis

5.0 - 9.0 years

0 Lacs

hyderabad, telangana

On-site

About Us At Zelis India, our mission is to enhance the healthcare financial experience by developing and implementing innovative solutions. We are dedicated to optimizing technology and processes for efficiency and effectiveness. Our collaborative work culture, leadership development initiatives, and global exposure opportunities create a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we strive to provide a holistic workplace experience. Our team at Zelis India maintains high standards of service delivery and contributes to our award-winning culture. Position Overview As a m...

Posted 2 months ago

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Dispute Resolution II Zelis

5.0 - 9.0 years

0 Lacs

hyderabad, telangana

On-site

As a Provider Dispute Specialist at our organization, you will play a crucial role in reviewing provider disputes related to DRG Coding and Clinical Validation, Itemized Bill Review, and Clinical Chart Review. Your responsibilities will include submitting explanations of dispute rationale back to providers within the designated timeframe to ensure client turnaround times are met. You will be accountable for managing claim dispute volume on a daily basis, adhering to client turnaround time, and department Standard Operating Procedures. In this role, you will serve as a subject matter expert for the Expert Claim Review Team, providing support on day-to-day activities, troubleshooting, and ensu...

Posted 2 months ago

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Project Lead - Pharmacovigilance DDReg Pharma Pvt. Ltd.

3.0 - 7.0 years

0 Lacs

haryana

On-site

The Project Lead Pharmacovigilance position at DDReg offers a compelling opportunity for you to advance your career in pharmacovigilance project management. As a crucial member of the Project Management team, you will play a key role in overseeing and directing all pharmacovigilance services. Your responsibilities will include serving as the primary contact for clients, ensuring project activities align with client needs and regulatory requirements, and maintaining high-quality work standards to achieve client satisfaction. Your key accountabilities in this role will involve closely managing client relations by acting as the main liaison between clients and project teams. You will be respons...

Posted 3 months ago

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