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1.0 - 5.0 years

0 Lacs

chennai, tamil nadu

On-site

As a member of the clinical support team at UnitedHealth Group, you play a crucial role in ensuring high-quality care and customer satisfaction. Your responsibilities include managing member intake, handling admission/discharge information, and collaborating with healthcare facilities to process service requests effectively. Your role also involves managing referrals, triaging cases, and providing care coordination notifications. In this fast-paced customer service environment, efficiency and thoroughness are key when interacting with members over the phone. You will need to be adept at multitasking, as well as be available to work flexible schedules, including evening hours. Key Responsibilities: - Managing member intake and admission/discharge information - Coordinating service requests with healthcare providers - Processing referrals and prior authorizations - Providing care coordination notifications for non-clinical cases - Resolving inquiries from members and providers Qualifications: - High School Diploma or GED - 1 year of customer service experience - Proficiency in Microsoft Word and Excel - Ability to multitask and navigate through multiple screens Preferred Qualifications: - Experience in the healthcare industry - Background in clerical or administrative support - Knowledge of ICD-9 and CPT codes - Familiarity with Medicare and/or Medicaid Services - Call center experience - Exposure to metric-driven work environments Join us at UnitedHealth Group and be part of a team dedicated to improving healthcare delivery. If you are ready to make an impact and do your best work, this is the opportunity for you. At Optum, a subsidiary of UnitedHealth Group, we are committed to innovating healthcare and making a positive impact on people's lives. By working with some of the brightest minds in the industry, you will tackle complex challenges that drive meaningful change. If you are passionate about driving healthcare forward and eager to be part of a dynamic team, join us at Optum and seize the opportunity to excel in your career. UnitedHealth Group promotes diversity and maintains a drug-free workplace. Candidates will undergo a drug test as part of the employment process. Location: Chennai, Tamil Nadu, IN Apply now to be a part of our team and contribute to creating a healthier atmosphere through your work at UnitedHealth Group.,

Posted 4 days ago

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5.0 - 7.0 years

0 Lacs

chennai, tamil nadu, india

Remote

Positions General Duties and Tasks: . Process BPO Insurance Claims timely and qualitatively . Meet & Exceed Production, Productivity and Quality goals . Review BPO 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 incase of emergency. Broadband connection is must while working from home. . Currently the Business is looking out for candidates who can work from NTT Data DLF Office at Chennai location for Night shift. Preferences for this role include: . 5+ years of experience processing BPO 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 5 days ago

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3.0 - 5.0 years

0 Lacs

chennai, tamil nadu, india

Remote

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 Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals 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. ..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. Requirements for this role include: . 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: 3+ 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.

Posted 2 weeks ago

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3.0 - 5.0 years

0 Lacs

chennai, tamil nadu, india

Remote

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 Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing Be a team player and work seamlessly with other team members on meeting customer goals 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. ..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. Requirements for this role include: . 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: 3+ 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.

Posted 2 weeks ago

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1.0 - 8.0 years

0 Lacs

maharashtra

On-site

If you are looking to advance your healthcare career and gain a deeper understanding of healthcare revenue cycle management, it is essential to view your healthcare business processes through the lens of the customer. Access Healthcare offers you the opportunity to enhance your expertise in the business of healthcare, join a company that recognizes and values your contributions, and allows you to evolve into a trusted partner for your clients. You will be supported in your professional growth and empowered to focus on key performance indicators that are crucial for your clients. As a Client Partner for medical coding - Denial services at Access Healthcare in Mumbai, India, you will play a pivotal role in auditing the coding of medical records, ensuring accurate diagnosis and CPT codes are assigned in accordance with ICD-10 and CPT-4 systems. Your responsibilities will include efficiently coding and auditing outpatient and/or inpatient records with a minimum accuracy rate of 96% within specified turnaround times. By exceeding productivity standards and upholding professional and ethical practices, you will contribute to revenue optimization for clients while adhering to industry standards. To excel in this role, you must possess excellent communication skills, a solid understanding of coding procedures and medical terminology in an ambulatory setting, and proficiency in medical coding and billing systems, regulatory requirements, auditing concepts, and principles. Continuous improvement is key, and you will be encouraged to enhance your coding skills and knowledge through participation in coding team meetings and educational conferences. The ideal candidate will have 1 to 8 years of experience in Medical Coding and be well-versed in CPT-4, ICD-9, ICD-10, and HCPCS coding. Possession of CCS/CPC/CPC-H/CIC/COC certification from AAPC/AHIMA is mandatory for this role, demonstrating your commitment to excellence in medical coding practices. Join Access Healthcare's dynamic team and embark on a rewarding career journey where your skills and expertise will be valued and nurtured.,

Posted 1 month ago

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4.0 - 6.0 years

0 Lacs

Gurugram, Haryana, India

On-site

Skills & Qualifications Exp - 4-6 years in Real world data analysis Qualification - Masters/PhD in statistics, M. Tech, M. Pharma Strong foundation in large database analysis, biostatistics, clinical trial, observational research and epidemiology Experience with handling large databases like administrative claims, electronic health records, patient chart review, Ability to manage multiple projects and deliver results under tight timelines Excellent interpersonal skills and analytical thoughts Tool & Platform Expertise Healthcare coding system ICD9 and 10, HCPCS, CPT, NDC etc. Use programming languages and tools such as SAS, R, R-Shiny, SQL, Python, Power BI Familiarity with RWE platforms like AWS, SAGEMAKER, AZURE and data standards like CDISC Core Responsibilities Data Analysis & Interpretation Analyse large datasets from sources like electronic health records, claims databases, and registries Apply statistical methods to assess patient journey, treatment outcomes, and healthcare utilization and capable to provide key insights and takeaways Study Design & Execution Develop protocols, statistical analysis plans, and research proposals Conduct observational studies and retrospective analyses using real-world data Collaboration & Communication Work cross-functionally with medical affairs, epidemiology, health economics, and commercial teams Excellent presentation skills Don&apost meet every job requirement That&aposs okay! Our company is dedicated to building a diverse, inclusive, and authentic workplace. If you&aposre excited about this role, but your experience doesn&apost perfectly fit every qualification, we encourage you to apply anyway. You may be just the right person for this role or others. Show more Show less

Posted 1 month ago

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1.0 - 10.0 years

0 - 0 Lacs

chennai, tamil nadu

On-site

As a Same Day Surgery Medical Coder, you will be responsible for handling the day-to-day operations of Same-day Surgery Coding. Your primary tasks will include coding records according to prescribed coding standards such as ICD-9/ICD-10 and CPT, assigning diagnosis and procedure codes for patient charts, and ensuring adherence to the company's Coding Compliance policy/plan. It is essential to have a minimum of two years of Same-day Surgery Coding experience and hold a CPC or COC certification. A graduation in Life Science or medical sciences is also required. Your role will involve working towards service levels to meet productivity and quality requirements. You will be expected to improve performance based on feedback provided by the reporting manager and prepare and maintain status reports. This position is based in Chennai and offers a salary ranging from 4 to 7.5 LPA Max. The work timings are during the day shift with Saturday and Sunday as fixed offs. The ideal candidate for this position must have CCS or CIC certification, with a preference for CPC or COC certification. The job falls under the Healthcare & Life Sciences functional area in the BPO/KPO Call Centre industry. This is a full-time, permanent employment opportunity. If you meet the qualifications and experience required for this role, please share your updated CV with raghu@starworthglobal.com or contact 9176668384 to express your interest.,

Posted 1 month ago

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2.0 - 6.0 years

0 Lacs

chennai, tamil nadu

On-site

As a Quality Control Analyst - Coding at Omega Healthcare Management Services Private Limited in Chennai, Tamil Nadu, you will play a crucial role in ensuring the quality requirements are met from both a process perspective and for targets set by the organization. Your responsibilities will include identifying methods to achieve quality targets, implementing them in consultation with the operations manager/team manager, and identifying errors efficiently during inspections. You will be required to actively participate in client calls, provide feedback face-to-face and via emails on errors identified, and ensure the correction of errors by the respective operations associates. Coaching employees to minimize errors, providing inputs to enhance training curriculum based on common mistakes observed, and testing files/batches for new clients/processes are also key aspects of this role. Additionally, you will be responsible for generating QA reports on a daily basis, meeting and exceeding internal and external SLAs as per defined processes, maintaining quality status reports, and ensuring strict adherence to company policies and procedures. Your role will involve conducting quality audits, coaching, and training sessions as per the defined process, requiring a minimum of 1.5 years of professional and relevant experience in the field. To excel in this role, you must possess sound knowledge of healthcare concepts, critical problem-solving skills, good analytical abilities, and judgmental skills. It is essential to have a good understanding of product and process knowledge, and to conduct quality feedback and refresher sessions regularly. If you are looking for a challenging opportunity to enhance your quality control skills and contribute to maintaining high standards in healthcare coding, this position offers a platform to showcase your expertise and make a significant impact within the organization.,

Posted 1 month ago

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2.0 - 6.0 years

0 Lacs

karnataka

On-site

Huron assists its clients in driving growth, enhancing performance, and maintaining leadership in their respective markets. Healthcare organizations are supported in fostering innovation capabilities and accelerating key growth initiatives, enabling them to shape the future rather than be disrupted by it. Collaboratively, clients are empowered to achieve sustainable growth, improve internal processes, and enhance consumer outcomes. Health systems, hospitals, and medical clinics face significant pressure to enhance clinical outcomes and reduce the cost of patient care. Merely investing in new partnerships, clinical services, and technology is insufficient to bring about meaningful change. To ensure long-term success, healthcare organizations must empower their leaders, clinicians, employees, affiliates, and communities to cultivate cultures that promote innovation for optimal patient outcomes. Joining the Huron team entails aiding clients in adapting to the rapidly evolving healthcare landscape, optimizing existing business operations, enhancing clinical outcomes, creating a more consumer-centric healthcare experience, and fostering engagement among physicians, patients, and employees throughout the enterprise. The role entails overseeing the day-to-day production and quality functions of a team of coders focused on achieving client production and coding accuracy goals. This includes planning, directing, supervising, evaluating feedback workflows, and coordinating activities among all coding staff within the team. Excellent communication skills, attention to detail, as well as strong technical and problem-solving abilities are crucial for success in this position. JOB DETAILS: - Assign accurate diagnosis and CPT codes in accordance with ICD-10 and CPT-4 coding systems for medical records - Code outpatient and/or inpatient records with a minimum accuracy of 96% and meeting turnaround time requirements - Exceed productivity standards for Medical Coding as per inpatient and/or specialty-specific outpatient coding norms - Uphold professional and ethical standards while focusing on continuous improvement to prevent revenue leakage and ensure compliance - Enhance coding skills, knowledge, and accuracy through participation in coding team meetings and educational conferences - Specialize in areas such as Inpatient, E&M, Acute, Ambulatory, Cardiology, Radiology, Pathology, Anesthesia, Emergency Room, Surgery, among others - Familiarity with CPT-4, ICD-9, ICD-10, and HCPCS coding - Interpret client requirements and project specifications to code charts accordingly - Adhere to prescribed coding standards like ICD-9/ICD-10 and CPT while ensuring accuracy and correctness of patient information - Assign appropriate medical codes to diagnoses and services, following client-specific guidelines and updates - Meet client productivity targets within specified timelines and deliver quality outputs - Prepare and maintain status reports QUALIFICATIONS: - Graduation in Life Science, Pharmacy, Physiotherapy, Zoology, Microbiology disciplines - Minimum of 2 years of industry experience - CPC (Certified Coding Professional) or CCS (Certified Coding Specialist) certification Position Level: Senior Analyst Country: India,

Posted 1 month ago

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5.0 - 7.0 years

0 Lacs

Chennai, Tamil Nadu, India

Remote

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 3 months ago

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