5.0 - 9.0 years

0 Lacs

hyderabad, telangana

On-site

You have a minimum of 5 years of experience in the US Healthcare industry. Your expertise includes: - Claims processing - Medical Billing experience in Medicare or commercial line - Experience in Contract configuration, with specific knowledge on Division of Financial responsibility work - Strong knowledge of Managed Care, specifically Medicare Advantage, Commercial, or Medi-cal - Ability to translate agreements/contracts into a matrix for codification - Contract interpretation - Understanding of financial responsibility related to healthcare (Division of Financial Responsibility) - Understanding of contracting - Extensive understanding of billing including service code, rev code, diagnosis,...

Posted 1 week ago

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Insurance Coordinator Healing Hands Clinic PVT LTD

1.0 - 5.0 years

0 Lacs

maharashtra

On-site

The Insurance Coordinator plays a crucial role in the healthcare revenue cycle, ensuring accurate insurance verification, pre-authorizations, claims submission, and follow-up. By coordinating insurance benefits and minimizing financial barriers for patients, this role supports access to care while upholding compliance with healthcare regulations. Key Responsibilities: Insurance Verification & Authorization: - Verify patient insurance coverage and benefits before appointments and procedures. - Obtain prior authorizations and referrals required by insurers for medical services. - Communicate any insurance limitations or requirements to clinical and administrative staff. Claims Processing & Fol...

Posted 1 month ago

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Utilization Management Specialist SHAI

0.0 - 4.0 years

0 Lacs

chennai, tamil nadu

On-site

We are seeking a motivated and detail-oriented Utilization Management Specialist to join our team. In this role, you will play a crucial part in reviewing medical information to ensure the necessity of healthcare services and adherence to best practices. Your responsibilities will include supporting the approval of cost-effective healthcare services that align with patient needs. You will be tasked with reviewing outpatient procedures, inpatient admissions, home health, and behavioral health services to determine their necessity. Collaborating with providers and medical directors to obtain prior authorization and plan case reviews when necessary will be an essential aspect of your role. Addi...

Posted 2 months ago

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