2.0 - 6.0 years

0 Lacs

nagpur, maharashtra

On-site

As a Premium Auditor at Trivium, you will be responsible for conducting virtual audits on Workers Compensation and General Liability policies for various insurance companies. Your main purpose will be to gather data from the insureds" place of business and compile it into a concise report for the carrier, ensuring accurate premium bases for policies. Your job duties will include performing E-audits or virtual audits through email or phone communication with the insureds/clients. You will need to examine and compile data from various financial records and present it in a detailed report. As a qualified applicant, you will be in charge of scheduling and managing your own appointments and workloads. To excel in this role, you must possess strong verbal communication skills and have a working knowledge of WCIRB, NCCI, and ISO guidelines for business and employee classification. Being able to work independently, having advanced computer skills (Excel, Word, Outlook/Mailbox), and strong analytical and problem-solving skills are essential. You should also be able to conduct business professionally with third-party accountants or insurance agents/brokers and be open to feedback for improvement. Preferred candidates will have previous experience in conducting workers compensation or general liability audits and demonstrate quality customer service. Candidates with a background in Science and Engineering will be given preference. In addition to the above, you should be flexible to adapt to new situations, take ownership of your performance and development, and exhibit personal integrity and ethical behavior to build trust. The position is for an Associate/Sr. Associate on a full-time basis, with benefits such as health insurance, leave encashment, paid sick time, paid time off, and provident fund. The work schedule is fixed from Monday to Friday, with night shifts and US shifts available along with shift allowance. Applicants must have a Bachelor's degree, be proficient in English, and be available for night shifts. The work location is in person at Nagpur, Maharashtra, and the application deadline is 14/07/2025, with an expected start date of 04/08/2025.,

Posted 3 days ago

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Hiring For Manager & Sr. Manager- Medical Audit Virtuoso Staffing Solutions

6.0 - 11.0 years

10 - 12 Lacs

New Delhi, Gurugram, Delhi / NCR

Work from Office

Roles and Responsibilities Conduct medical audits for high-value claims, including inpatient and outpatient services. Review NCCI guidelines to ensure accurate coding and compliance with US healthcare regulations. Analyze CPT codes to identify discrepancies and optimize claim processing. Collaborate with internal stakeholders to resolve issues related to claims adjudication. Develop expertise in dollar value claims handling, focusing on accuracy and efficiency. Desired Candidate Profile 6-11 years of experience in Medical Audit or Claims Auditing/Audition role. Strong understanding of CPT, ICD-10-CM/PCS, HCPCS Level II codes; knowledge of anesthesia codes (G0152) preferred. Experience working with High Value Claims (HVC) is essential; familiarity with NCCI guidelines a plus.

Posted 1 month ago

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Hiring General Surgery Coder / Hyderabad / Chennai Coronis IT

2 - 7 years

3 - 8 Lacs

Hyderabad, Chennai

Work from Office

We are looking for Experienced General Surgery Coders to join our growing team. The ideal candidate will have a strong background in surgical procedure coding across various specialties, including but not limited to general surgery, orthopedics, cardiovascular, and more. Role & responsibilities : Review and analyze medical records to assign appropriate CPT, ICD-10-CM, and HCPCS codes Ensure coding accuracy and compliance with official coding guidelines and payer requirements Work with clinical staff for clarifications and documentation improvement Maintain productivity and quality standards Preferred candidate profile Minimum 1 years of hands-on experience in surgical coding Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) Attention to detail and excellent analytical skills Strong knowledge of anatomy, medical terminology, and surgical procedures Perks and Benefits Competitive salary with incentives Continuous training and career development Supportive work culture Complimentary meals provided To Apply: Send your resume to - amith.baswaraj@coronishealth.com For more details, contact us at 8971789084

Posted 3 months ago

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Clinical Policy Review Analyst | MNC | Hyderabad | WFO | V3 Staffing

3.0 - 8.0 years

7 - 7 Lacs

hyderabad

Work from Office

Greetings of the day ! Our reputed MNC Client is hiring for Clinical Policy Review Analyst role: Job Description: As a Clinical Policy Review Analyst, you will be responsible for providing in-depth clinical coding analysis of professional and facility claims, maintaining up-to-date clinical guidelines, and ensuring compliance with industry standards. Key Responsibilities: - Provide clinical coding analysis of professional and facility claims routed to the Clinical Policy Review queue - Maintain current industry knowledge of claim edit references, including AMA, CMS, NCCI, and other relevant guidelines - Conduct research on coding scenarios and provide data-driven insights and business recommendations - Collaborate with cross-functional teams to identify and resolve edit performance issues - Assist in creating and maintaining job aides and guidelines for review and claims workflow process improvements Requirements: - 3+ years of relevant experience in healthcare payers/claims payment processing - Certified Coder (CCS, CCS-P, or CPC) with a strong understanding of clinical policy interpretation and claims workflow - Knowledge of payer reimbursement policies, state and federal regulations, and applicable industry standards - Excellent analytical, problem-solving, and communication skills - Ability to work independently and collaboratively in a team environment Preferred Qualifications: - Experience with medical records review and NCCI editing - Strong understanding of US healthcare system and federal websites (CMS, FDA, etc.) Warm Regards, Gayatri Kumari Email Id: gayatri@v3staffing.in V3 Staffing Solutions

Posted Date not available

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