3.0 - 7.0 years

0 Lacs

kochi, kerala

On-site

As a Reviewer of Precertification Requests, your role involves evaluating requests for medical necessity based on clinical policy guidelines. Your responsibilities include: - Reviewing precertification requests to determine medical necessity according to established guidelines - Verifying the eligibility and benefits of members" coverage - Communicating effectively with network providers and members to gather additional information as needed - Providing unbiased recommendations based on the medical records provided - Collaborating with Medical Directors to refer cases that do not meet guidelines initially - Assessing the appropriate length of hospital stays using Milliman Care Guidelines - E...

Posted 2 days ago

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Prior Authorization QA || Hyderabad || upto 47k + 2 Way Cab Axis Services

4.0 - 8.0 years

5 - 6 Lacs

hyderabad

Work from Office

Were Hiring Prior Authorization QA | Hyderabad (Gachibowli) Eligibility 4+ Years in Prior Auth 1+ Year as QA (On/Off papers, but must be QA exp) Must have Clinical Review Process experience with Life Science background Qualification: Inter & Above Salary: Up to 47K Take-Home 2-Way Cab (30 KM radius) Night Shift (6:30 PM – 3:30 AM) Hyderabad – Gachibowli Immediate Joiners (Relieving letter not mandatory) Apply Now: Dharani – 9100982938 (WhatsApp your resume) dharani.palle@axisservice.co.in Referrals are Welcome – Share with friends & colleagues!

Posted 1 month ago

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Coding Auditor, IP Workstream Med-Metrix

5.0 - 9.0 years

0 Lacs

chennai, tamil nadu

On-site

Role Overview: As a Coding Auditor, you will be responsible for inpatient and outpatient coding and auditing for various specialties. Your role will also involve preparing and presenting audit results to internal and external parties. Key Responsibilities: - Perform coding audits and compliance audits for providers, including physicians and mid-level providers - Prepare reports of audits and present findings to relevant parties - Apply appropriate coding and documentation guidelines accurately, such as E&M and surgery documentation guidelines, CCI guidelines, CPT/HCPCS coding guidelines, and specialty association guidance - Provide physician education based on audit findings or edit and deni...

Posted 1 month ago

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Senior Coding Specialist Auditor IKS Health

0.0 years

0 Lacs

mumbai, maharashtra, india

On-site

.Performing thorough audit and providing feedback to coders on daily basis. .Thorough understanding and application of medical necessity, APC for processing charts. .Querying physicians regarding incomplete documentation. .Day-to-day management of quality related issues.

Posted 2 months ago

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