Medical / Insurance Claims Analytics Consultant Minutes to Seconds

3.0 - 7.0 years

0 Lacs

karnataka

On-site

MinutestoSeconds is a dynamic organization specializing in outsourcing services, digital marketing, IT recruitment, and custom IT projects. We partner with SMEs, mid-sized companies, and niche professionals to deliver tailored solutions. As a Medical / Insurance Claims Analytics Consultant at MinutestoSeconds, you will have the opportunity to work on various projects aimed at improving healthcare claims processes and enhancing member experiences. **Key Responsibilities:** - Reducing Claims Friction: You will contribute to use cases that have already reduced Medicare claim rejections by 7% and re-submissions by 70%. - Driving Automation: Your role will involve automating pre-authorization and...

Posted 3 weeks ago

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Utilization Review Representative Zealie India Pvt Ltd

6.0 - 10.0 years

0 Lacs

karnataka

On-site

Role Overview: Zealie, a fast-growing Medical Billing Services company specializing in the Behavioral Healthcare industry, is seeking a Utilization Review (UR) Representative to play a crucial role in managing and coordinating authorization processes while ensuring compliance with insurance and regulatory requirements. The successful candidate will work closely with clinical teams and insurance providers to advocate for optimal patient care through advanced responsibilities and adherence to strict compliance standards and HIPAA regulations. Key Responsibilities: - Lead and Oversee Authorization Processes: Direct and manage authorization processes for assigned facilities, ensuring timely acqu...

Posted 1 month ago

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Dental Advisor The Cigna Group

3.0 - 7.0 years

0 Lacs

karnataka

On-site

As a Medical Claims Review Senior Analyst/Clinical Supervisor in the Complex Claim Unit, you will provide clinical review expertise for high dollar and complex claims, including facility and professional bills. Your role includes identifying coding and billing errors, ensuring the application of Medical and Reimbursement Policies for cost containment, and identifying cases for potential fraud and abuse. Your major responsibilities will involve evaluating medical information against criteria, benefit plans, and coverage policies to determine the necessity for procedures. In cases where criteria are not met, you will refer to the Medical Director. You will also evaluate itemized bills against ...

Posted 1 month ago

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