Medical Abstractor & Clinical Auditor

Key Responsibilities:

• Review the Medical Coding Console:
• Regularly review the Medical Coding Console numbers for assigned hospitals or insurance groups to ensure timely processing of the Discharge Summaries
• Review Incomplete DS Dashboard:
• Push discharge summaries from the Incomplete DS dashboard as required.
• Quality Assurance:
• Maintain a quality score of 98% or higher by ensuring discharge summaries are accurately mapped to their respective medical conditions and specialities.
• Team Coordination:
• Collaborate with other medical abstractors to ensure daily inventory is completed and no items remain pending.
• Identifying Wrong Discharge Summaries:
• Notify the Program Manager/Client Account Lead about any incorrect discharge summaries requiring deletion and send the necessary email for resolution.
• Mapping for New Clients:
• Assist in mapping discharge summaries for new clients during the implementation phase.

The primary duties as a Quality Auditor include: -

• Performing audit functions for the members of the care management teams with the objective to ensure all the regulatory and quality standards are met.
• Listen to the health care coach’s call recording.
• Ensure that the health care coaches have followed the process workflow, asked all relevant symptoms and questions to the patients.
• Have an eye for detail for any deviation from the expected call flow.
• Process Improvement through continuous feedback and coaching.
• Review complete call quality.
• Maintaining tracking tools to log audit results including areas of non-compliance and identifying areas of improvement.
• Training the care management teams on all the gaps as identified using quality assessments.
• Evaluate and analyze aggregate quality performance data.

Skills and Qualifications:

• Strong attention to detail and organizational skills.
• Proficiency in medical terminology and understanding of discharge summaries.
• Ability to meet quality benchmarks and adhere to deadlines.
• Effective communication and coordination skills.
• Familiarity/Experience working on Patient Care Co-ordination digital platforms .

What We Offer:

• A collaborative work environment.
• Opportunities for professional growth and development.
• Competitive compensation package.
• Paid Sick Days
• Health Insurance
• Work hour flexibility
• Work from home

Job Type: Full-time

Pay: ₹250,000.00 - ₹318,000.00 per year

Benefits:

• Health insurance
• Leave encashment
• Paid time off
• Provident Fund
• Work from home

Schedule:

• Day shift

Supplemental Pay:

• Performance bonus
• Yearly bonus

Experience:

• total work: 1 year (Preferred)

Work Location: In person