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3 Medicare Guidelines Jobs

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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 3 weeks ago

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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 3 weeks ago

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1.0 - 5.0 years

0 Lacs

noida, uttar pradesh

On-site

As an Executive in the US Medicare Process team, you will be responsible for managing healthcare claims, verifying medical eligibility, and ensuring compliance with Medicare guidelines. With 1-4 years of experience in the field, you will play a crucial role in processing Medicare claims accurately and resolving any discrepancies that may arise. Your role will involve handling inbound and outbound calls for claim inquiries, updating medical eligibility records as per Medicare regulations, and reviewing healthcare provider documentation in alignment with US Medicare standards. Your key responsibilities will include processing Medicare claims with precision, verifying and updating medical eligi...

Posted 1 month ago

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