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0 years
0 Lacs
Gurgaon, Haryana, India
On-site
Overview We are seeking an experienced Data Modeller with expertise in designing and implementing data models for modern data platforms. This role requires deep knowledge of data modeling techniques, healthcare data structures, and experience with Databricks Lakehouse architecture. The ideal candidate will have a proven track record of translating complex business requirements into efficient, scalable data models that support analytics and reporting needs. About The Role As a Data Modeller, you will be responsible for designing and implementing data models for our Databricks-based Modern Data Platform. You will work closely with business stakeholders, data architects, and data engineers to create logical and physical data models that support the migration from legacy systems to the Databricks Lakehouse architecture, ensuring data integrity, performance, and compliance with healthcare industry standards. Key Responsibilities Design and implement logical and physical data models for Databricks Lakehouse implementations Translate business requirements into efficient, scalable data models Create and maintain data dictionaries, entity relationship diagrams, and model documentation Develop dimensional models, data vault models, and other modeling approaches as appropriate Support the migration of data models from legacy systems to Databricks platform Collaborate with data architects to ensure alignment with overall data architecture Work with data engineers to implement and optimize data models Ensure data models comply with healthcare industry regulations and standards Implement data modeling best practices and standards Provide guidance on data modeling approaches and techniques Participate in data governance initiatives and data quality assessments Stay current with evolving data modeling techniques and industry trends Qualifications Extensive experience in data modeling for analytics and reporting systems Strong knowledge of dimensional modeling, data vault, and other modeling methodologies Experience with Databricks platform and Delta Lake architecture Expertise in healthcare data modeling and industry standards Experience migrating data models from legacy systems to modern platforms Strong SQL skills and experience with data definition languages Understanding of data governance principles and practices Experience with data modeling tools and technologies Knowledge of performance optimization techniques for data models Bachelor's degree in Computer Science, Information Systems, or related field; advanced degree preferred Professional certifications in data modeling or related areas Technical Skills Data modeling methodologies (dimensional, data vault, etc.) Databricks platform and Delta Lake SQL and data definition languages Data modeling tools (erwin, ER/Studio, etc.) Data warehousing concepts and principles ETL/ELT processes and data integration Performance tuning for data models Metadata management and data cataloging Cloud platforms (AWS, Azure, GCP) Big data technologies and distributed computing Healthcare Industry Knowledge Healthcare data structures and relationships Healthcare terminology and coding systems (ICD, CPT, SNOMED, etc.) Healthcare data standards (HL7, FHIR, etc.) Healthcare analytics use cases and requirements Optionally Healthcare regulatory requirements (HIPAA, HITECH, etc.) Clinical and operational data modeling challenges Population health and value-based care data needs Personal Attributes Strong analytical and problem-solving skills Excellent attention to detail and data quality focus Ability to translate complex business requirements into technical solutions Effective communication skills with both technical and non-technical stakeholders Collaborative approach to working with cross-functional teams Self-motivated with ability to work independently Continuous learner who stays current with industry trends What We Offer Opportunity to design data models for cutting-edge healthcare analytics Collaborative and innovative work environment Competitive compensation package Professional development opportunities Work with leading technologies in the data space This position requires a unique combination of data modeling expertise, technical knowledge, and healthcare industry understanding. The ideal candidate will have demonstrated success in designing efficient, scalable data models and a passion for creating data structures that enable powerful analytics and insights.
Posted 2 weeks ago
0 years
0 Lacs
Tiruchirappalli, Tamil Nadu, India
On-site
A medical coder is a crucial role in the healthcare revenue cycle by translating medical diagnoses, procedures, services, and equipment into standardised codes for billing, insurance claims, and record-keeping purposes. They ensure the accuracy of the coding process, compliance with regulations, and timely processing of claims 1. Coding and abstracting Reviewing clinical documentation: Analyze patient records, physician notes, lab results, and other reports to identify services rendered and diagnoses. Assigning appropriate codes: Utilize coding systems like ICD-10 (for diagnoses) and CPT/HCPCS (for procedures) to assign accurate codes that reflect the medical situation. Ensuring coding compliance: Adhere to coding guidelines and policies set by government regulations and insurance payers. 2. Maintaining coding quality and accuracy Performing chart audits: Conduct regular audits and coding reviews to ensure the accuracy and precision of documentation. Identifying and resolving discrepancies: Analyze medical records for missing or ambiguous information and communicate with healthcare providers to clarify documentation when needed. Staying updated with coding guidelines: Keep abreast of changes and updates in coding regulations, policies, and industry trends to maintain knowledge of best practices. Participating in quality improvement initiatives: Assist in maintaining coding quality metrics and actively engage in efforts to enhance accuracy and efficiency. 3. Collaboration and communication Collaborating with cross-functional teams: Work closely with healthcare providers, billing specialists, and compliance officers to ensure smooth coding and billing processes. Communicating with insurance companies: Address coding errors and disputes with insurance companies to ensure claims are processed correctly. Training and education: Provide training and support to clinical staff on documentation improvement initiatives, potentially including new coding guidelines. 5 days working , 9 hour shift, Rotational off.
Posted 2 weeks ago
0 years
0 Lacs
Salem, Tamil Nadu, India
On-site
A medical coder is a crucial role in the healthcare revenue cycle by translating medical diagnoses, procedures, services, and equipment into standardised codes for billing, insurance claims, and record-keeping purposes. They ensure the accuracy of the coding process, compliance with regulations, and timely processing of claims 1. Coding and abstracting Reviewing clinical documentation: Analyze patient records, physician notes, lab results, and other reports to identify services rendered and diagnoses. Assigning appropriate codes: Utilize coding systems like ICD-10 (for diagnoses) and CPT/HCPCS (for procedures) to assign accurate codes that reflect the medical situation. Ensuring coding compliance: Adhere to coding guidelines and policies set by government regulations and insurance payers. 2. Maintaining coding quality and accuracy Performing chart audits: Conduct regular audits and coding reviews to ensure the accuracy and precision of documentation. Identifying and resolving discrepancies: Analyze medical records for missing or ambiguous information and communicate with healthcare providers to clarify documentation when needed. Staying updated with coding guidelines: Keep abreast of changes and updates in coding regulations, policies, and industry trends to maintain knowledge of best practices. Participating in quality improvement initiatives: Assist in maintaining coding quality metrics and actively engage in efforts to enhance accuracy and efficiency. 3. Collaboration and communication Collaborating with cross-functional teams: Work closely with healthcare providers, billing specialists, and compliance officers to ensure smooth coding and billing processes. Communicating with insurance companies: Address coding errors and disputes with insurance companies to ensure claims are processed correctly. Training and education: Provide training and support to clinical staff on documentation improvement initiatives, potentially including new coding guidelines. 5 days working , 9 hour shift, Rotational off.
Posted 2 weeks ago
0 years
0 Lacs
Hyderabad, Telangana, India
On-site
A medical coder is a crucial role in the healthcare revenue cycle by translating medical diagnoses, procedures, services, and equipment into standardised codes for billing, insurance claims, and record-keeping purposes. They ensure the accuracy of the coding process, compliance with regulations, and timely processing of claims 1. Coding and abstracting Reviewing clinical documentation: Analyze patient records, physician notes, lab results, and other reports to identify services rendered and diagnoses. Assigning appropriate codes: Utilize coding systems like ICD-10 (for diagnoses) and CPT/HCPCS (for procedures) to assign accurate codes that reflect the medical situation. Ensuring coding compliance: Adhere to coding guidelines and policies set by government regulations and insurance payers. 2. Maintaining coding quality and accuracy Performing chart audits: Conduct regular audits and coding reviews to ensure the accuracy and precision of documentation. Identifying and resolving discrepancies: Analyze medical records for missing or ambiguous information and communicate with healthcare providers to clarify documentation when needed. Staying updated with coding guidelines: Keep abreast of changes and updates in coding regulations, policies, and industry trends to maintain knowledge of best practices. Participating in quality improvement initiatives: Assist in maintaining coding quality metrics and actively engage in efforts to enhance accuracy and efficiency. 3. Collaboration and communication Collaborating with cross-functional teams: Work closely with healthcare providers, billing specialists, and compliance officers to ensure smooth coding and billing processes. Communicating with insurance companies: Address coding errors and disputes with insurance companies to ensure claims are processed correctly. Training and education: Provide training and support to clinical staff on documentation improvement initiatives, potentially including new coding guidelines. 5 days working , 9 hour shift, Rotational off.
Posted 2 weeks ago
2.0 - 6.0 years
0 Lacs
chennai, tamil nadu
On-site
Greetings from Shiash Info Solutions! We are looking for experienced ED Fac/Profee Coders to join our team in Chennai. The ideal candidate should have a minimum of 2 years of experience in this field and be certified. Immediate joiners are preferable for this full-time on-site role. As an ED Coder at Shiash Info Solutions, your primary responsibility will be to handle day-to-day coding tasks associated with emergency department medical records. You will play a crucial role in ensuring accurate coding practices that comply with regulations and coding guidelines. To excel in this role, you should demonstrate proficiency in medical coding and classification systems such as ICD-10-CM and CPT. A strong knowledge of medical terminology, anatomy, and physiology is essential. Understanding healthcare regulations and compliance requirements is crucial for this position. Attention to detail and accuracy in coding practices are key attributes we are looking for. Additionally, effective communication skills and the ability to collaborate within a team environment are important. If you meet the qualifications and are interested in this opportunity, please share your resume with us at shiash.amaldia@gmail.com. For further inquiries, you can reach out to us at 6379869508. We look forward to receiving your application and potentially welcoming you to our team at Shiash Info Solutions in Chennai!,
Posted 2 weeks ago
1.0 - 2.0 years
0 Lacs
Mumbai Metropolitan Region
On-site
We are seeking a dynamic and experienced Affiliate Executive to join our team. The ideal candidate should possess a deep understanding of publishers and other related platforms, with a preference for candidates with existing publisher relations. With 1-2 years of relevant experience, the candidate will be responsible for driving business growth by forging strong partnerships with publishers, understanding their needs, and offering tailored solutions to optimize their monetization strategies. The candidate will be responsible for identifying, onboarding, and managing new local and international publishers. This is a crucial position for our company’s growth, requiring someone with a strong work ethic, eagerness to learn, proficient in English communication- both written and verbal and the ability to build long-term relationships with publishing partners Responsibilities: · Research and source new affiliate partners. · Planning and Executing CPL, CPC, CPV, CPI, and Video campaigns. · Identifying, evaluating, and recruiting new affiliates to run CPL | CPI | CPT | CPV campaigns, adding to the company’s supply sources. · Hands experience in Ads-Ops for S2S integrations of Postback URL & Pixel integration with varied tracking platforms like – Cake, Has Offers, etc. & analytical tools like – AppsFlyer, MAT, Branch and Apsalar. · Send reports to Publishers that include campaign performance. · Produce monthly reporting and analysis of publisher payments for internal distribution and execution requirements: Requirements: 1 - 2 years of experience in publisher management, business development, affiliate marketing, or digital advertising Excellent communication skills in English (both spoken and written) Strong interpersonal and negotiation skills Ability to work independently and as part of a team Willingness to learn, adapt, and grow in a fast-paced environment Self-motivated with a passion for digital media and technology Understanding of affiliate marketing, programmatic advertising, or influencer marketing Hands-on experience in configuring and managing ads through mediation tools for mobile and online CRM experience is preferred
Posted 2 weeks ago
0 years
0 Lacs
Kochi, Kerala, India
Remote
🎯 Wanted: A Senior Business Analyst Who Can Decode US Healthcare Without Needing a Nap After Let’s set the record straight: BlueBriX isn’t your average healthcare tech company. We’re the crew that believes “value-based care” should actually, you know, deliver value. And our platform? It’s the digital backbone helping providers do just that—without resorting to sticky notes, Excel nightmares, or 2 AM coffee-fuelled guesswork. We’re hunting for a Senior Business Analyst who can translate the chaos of US healthcare into crisp, actionable plans—without dissolving into existential despair. You’ll Know This Role is For You If: You’ve ever stared into the abyss of a 300-page payer contract and thought, Challenge accepted. You can explain CPT codes, prior authorizations, and MACRA without Googling mid-sentence. You think “requirements gathering” is more than just nodding while someone rambles. You’ve seen a workflow diagram so convoluted it looked like modern art—and you fixed it. You can tell the difference between a user story, a business rule, and an excuse. You have opinions (the informed kind) about what makes US healthcare tick—and how tech can actually help. What You’ll Actually Be Doing (Besides Being the Adult in the Room): Diving headfirst into the murky waters of US healthcare processes, payer mandates, and regulatory fun. Translating product vision into clear, unambiguous requirements the engineering team can build without psychic powers. Collaborating with product managers, designers, and developers to make sure everyone’s speaking the same language. Validating that what we ship actually solves real problems for real users (not just the ones in pitch decks). Mapping complex workflows, identifying gaps, and proposing solutions that don’t require hiring an army of consultants. Balancing the urgent (“the client needed this yesterday”) with the important (“we should build this right the first time”). 🧭 Reporting To: You’ll report to the VP of Product . But let’s be honest—if you’re good at this, you’ll spend most of your time embedded with cross-functional teams, championing clarity and sanity. 📈 Metrics That Matter (AKA: How We’ll Know You’re Not Just Making Flowcharts for Fun): Requirements sign-offs happen on time—and actually reflect reality. Features launch without the support team turning into an overwhelmed helpdesk. User acceptance testing doesn’t uncover more surprises than a reality TV finale. Stakeholders say, “This makes sense,” more often than, “Wait, what are we building again?” You help reduce rework because you asked the right questions upfront. 💡 Real Talk: This is not a remote job. We need you here in Kochi, where hallway conversations and whiteboard sessions solve problems faster than any Slack thread ever could. We don’t do kombucha bars or beanbag chair fortresses. What we do offer: ownership, impact, and a team that wants you to bring your brain (and maybe your sense of humor) every day. 🚫 Who Shouldn’t Apply: People who think “healthcare domain knowledge” means watching an episode of Grey’s Anatomy. Folks who need a manager to remind them what they’re supposed to be doing. Anyone still arguing that ICD-10 codes are just a passing trend. 🎤 Final Words (Cue Dramatic Music): If you’re sitting there thinking, “Finally—a role where my obsession with clarity, process, and US healthcare can actually help people,” then stop lurking and start applying. 👉 Apply now. Bring your brain, your experience, and maybe a flowchart. You’re going to need it.
Posted 2 weeks ago
2.0 - 6.0 years
0 Lacs
haryana
On-site
Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose the relentless pursuit of a world that works better for people we serve and transform leading enterprises, including the Fortune Global 500, with our deep business and industry knowledge, digital operations services, and expertise in data, technology, and AI. Inviting applications for the role of Business Analyst, Medical Coding In this role, you need to work as Medical coder for Provider Coding. Responsibilities Review medical records, patient medical history and physical exams, physician orders, progress notes, consultation reports, diagnostic reports, operative and pathology reports, and discharge summaries to verify the pertinent CPT and ICD 10 CM codes. To code on Medical reports by assigning appropriate CPT & ICD 10 CM codes based on the documentation and per the client specification. Follow project-specific guidelines without any deviation. Check the LCD policy per insurance specification. Performs assigned tasks/complete targets with speed and accuracy as per client SLAs Compliance with client/project guidelines, business rules, and training provided the company's quality system and policies. Communication / Issue escalation to supervisor if there is any in a timely manner. Willing to learn and keep self-updated with the updated codes. Work cohesively in a team setting. Assist team members to achieve shared goals. Qualifications we seek in you! Minimum Qualifications Must have relevant experience in Medical Coding any (ED, E/M, Urgent Care, Ancillary (Path/Lab/Rad) Thorough knowledge of CPT and ICD-10-CM/PCS, HCPCS Level II, Medicare, Medicaid, and Insurance guidelines. Coding certification: Mandatory CPC (AAPC) and/or CCS (AHIMA) Science graduate/BAMS/BHMS/BPT/BUMS and/or relevant equivalent and relevant work experience Preferred Qualifications/ Skills Relevant years general medical coding experience. Must possess computer skills including, but not limited to, Word, Excel, and PowerPoint. Experience with 3M and encoder preferred. Experience with an EPIC preferred. Must be able to use the internet and other electronic resources for the purpose of research. Advanced understanding of Professional coding guidelines, medical terminology, pharmacology, body systems/anatomy, physiology, and concepts of disease processes Job Business Analyst Primary Location India-Gurugram Schedule Full-time Education Level Bachelor's / Graduation / Equivalent Job Posting Apr 1, 2025, 8:46:35 PM Unposting Date Ongoing Master Skills List Operations Job Category Full Time,
Posted 2 weeks ago
0.0 - 4.0 years
0 Lacs
Pune, Maharashtra
On-site
Welcome to Veradigm! Our Mission is to be the most trusted provider of innovative solutions that empower all stakeholders across the healthcare continuum to deliver world-class outcomes. Our Vision is a Connected Community of Health that spans continents and borders. With the largest community of clients in healthcare, Veradigm is able to deliver an integrated platform of clinical, financial, connectivity and information solutions to facilitate enhanced collaboration and exchange of critical patient information. Veradigm Life Veradigm is here to transform health, insightfully. Veradigm delivers a unique combination of point-of-care clinical and financial solutions, a commitment to open interoperability, a large and diverse healthcare provider footprint, along with industry proven expert insights. We are dedicated to simplifying the complicated healthcare system with next-generation technology and solutions, transforming healthcare from the point-of-patient care to everyday life. For more information, please explore Veradigm.com. What will your job look like: RCM Manager ***This is a fully onsite position in Pune, Maharashtra Office-SHIFT 7:30PM IST – 4:30AM IST*** Support a Team of Go-Getters Our professional billing experts help organizations ensure accurate billing and coding, and partner with them at every step of the revenue cycle. Dedicated account managers deliver a comprehensive approach for improving the financial health of any practice. Job Summary: Manages an RCM team who are responsible for all related medical billing activities for the purpose of maximizing accounts receivable collections for clients. In addition to performing similar work, the Manager will oversee and ensure group productivity and performance in accordance with financial goals to ensure the health of the client's Accounts Receivable. Supports RCM Management by efficiently and effectively providing oversight and review of the team, processes and workload. What you will contribute: Strong customer service skills for client satisfaction, health of client AR and management of RCM team members o answering client inquiries; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally o acts as primary point of contact for team members and provides guidance on work matters Track clients' AR productivity and health (charge, payments, collections, adjustments) on a daily, weekly and/or monthly basis as needed to ensure the client and company expectations are met Analyze reports to determine when, how and why decrease in clients' AR; includes denials, unbilled, credit issues, holds; determine corrective actions and communicate with client and staff to resolve. Follow up to ensure actions are taken that achieve the results needed and/or determine other resolution needed Responsible for staff productivity for follow-up of all unpaid, denied, and underpaid and overpaid claims. This includes but is not limited to contacting insurance companies for claim status, reviewing all insurance claims and patient documentation, reviewing and ensuring appropriate coding, handling correspondence, and making appropriate decisions for follow-up action. Must be effective at handling several accounts simultaneously and ensuring maximum accounts receivable and expedient collection turnaround for clients. Meets with Client representatives to review billing progress, status of accounts and review and resolve any issues presented by clients. Ensures that staff and/or vendor, as applicable, enters all charges into the medical billing system accurately and correctly for reimbursement. This includes but is not limited to: ensuring correct CPT codes, modifiers, and ICD codes, authorizations for services, patient demographics, and health insurance data. Responsible for staff who enter all patient, insurance, and third-party payments into the medical billing system. This includes a thorough knowledge and understanding of medical EOB's, patient deductibles and co pays, insurance or third-party correspondence, contractual payments and adjustments. Interact with clients and their patients, engage in proactive resolution of issues and timely response to questions and concerns. Deliver timely required reports to the RCM Management; initiates and communicates the resolution of issues Meet regularly with staff; in-person and as a group to confirm the status of client accounts and build/sustain staff engagement to drive business results and improvements Remain current with company's policies and procedures regarding AR activity such as, reviewing month end reports to ensure the AR and cash collections are meeting agreed upon benchmarks, identifying trends, reviewing denial reports Review work performed by outside vendors for accuracy and production. Determine changes/improvement needed and works promptly and appropriate with applicable individuals to bring about such changes/improvement Achieve goals set forth by management and compliance requirements Follows, enforces and models adherence to all policies, procedures and processes An Ideal Candidate will have: Bachelor's Degree or equivalent Technical / Business experience (Required) 8+ years relevant work experience; 2-3 years at the Expert level or equivalent experience (Preferred) Experience working with India associates or vendor relationships (Preferred) 2-4 years relevant leadership experience (Preferred) Benefits Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work. Through our generous benefits package with an emphasis on work/life balance, we give our employees the opportunity to allow their careers to flourish. Quarterly Company-Wide Recharge Days Peer-based incentive "Cheer" awards "All in to Win" bonus Program Tuition Reimbursement Program To know more about the benefits and culture at Veradigm, please visit the links mentioned below: - https://veradigm.com/about-veradigm/careers/benefits/ https://veradigm.com/about-veradigm/careers/culture/ Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce. Thank you for reviewing this opportunity! Does this look like a great match for your skill set? If so, please scroll down and tell us more about yourself!
Posted 2 weeks ago
1.0 - 4.0 years
0 Lacs
Chennai, Tamil Nadu, India
Remote
Role : QA Analyst Experience : 1 to 4 Years Work Mode : WFO / Hybrid /Remote if applicable Immediate Joiners Preferred Responsibilities : Develop and execute test plans, test cases, and test scripts for healthcare claims processing systems. Perform functional, integration, regression, and end-to-end testing of claims applications. Verify the accuracy of claims data, including patient demographics, medical codes (CPT, ICD-10), and payment information. Test claims adjudication logic, ensuring compliance with payer rules and regulations. Validate electronic data interchange (EDI) transactions related to claims processing (e.g., 837, 835). Identify, document, and track software defects using bug tracking systems. Collaborate with developers to resolve defects and ensure timely resolution. Perform root cause analysis of defects to prevent recurrence. Work closely with business analysts, developers, and project managers to ensure quality throughout the software development lifecycle. Participate in requirements review and design sessions. Required Skills And Qualifications Bachelor's degree in a related field (e.g., Computer Science, Healthcare Administration). Experience : 2 - 8 years of testing exp. 3-4 of relevant experience working in US Healthcare Claims projects Techincal skill : Ability to execute SQL queries for data verification fluent in excel formulas & macros Proven experience in quality assurance testing, preferably in the healthcare industry. Strong understanding of US healthcare payer systems and claims adjudication processes. Knowledge of medical coding (CPT, ICD-10) and healthcare terminology. Familiarity with EDI transactions (837, 835). Experience with test management and bug tracking tools (e.g., Jira, TestRail). Excellent analytical and problem-solving skills. Strong attention to detail and accuracy. Excellent communication and interpersonal skills. Preferred : AHIP AHM 250 certification. (ref:hirist.tech)
Posted 2 weeks ago
2.0 years
0 Lacs
Bengaluru, Karnataka, India
On-site
Key Responsibilities: • Design and implement predictive models and machine learning algorithms to solve healthcare-specific challenges • Analyze large, complex healthcare datasets including electronic health records (EHR) and claims data • Develop statistical models for patient risk stratification, treatment optimization, population health management, and revenue cycle optimization • Build models for clinical decision support, patient outcome prediction, care quality improvement, and revenue cycle optimization • Create and maintain automated data pipelines for real-time analytics and reporting • Work with healthcare data standards (HL7 FHIR, ICD-10, CPT, SNOMED CT) and ensure regulatory compliance • Develop and deploy models in cloud environments while creating visualizations for stakeholders • Present findings and recommendations to cross-functional teams including clinicians, product managers, and executives Qualifications required: • Bachelor's degree in data science, Statistics, Computer Science, Mathematics, or related quantitative field • At least 2 years of hands-on experience in data science, analytics, or machine learning roles • Demonstrated experience working with large datasets and statistical modeling • Proficiency in Python or R for data analysis and machine learning • Experience with SQL and database management systems • Knowledge of machine learning frameworks such as scikit-learn, TensorFlow, PyTorch • Familiarity with data visualization tools such as Tableau, Power BI, matplotlib, ggplot2 • Experience with version control systems (Git) and collaborative development practices • Strong foundation in statistics, hypothesis testing, and experimental design • Experience with supervised and unsupervised learning techniques • Knowledge of data preprocessing, feature engineering, and model validation • Understanding of A/B testing and causal inference methods. What You’ll Need to Be Successful (Required Skills): • Large Language Model (LLM) Experience: At least 2 years of hands-on experience working with pre-trained language models (GPT, BERT, T5) including fine-tuning, prompt engineering, and model evaluation techniques • Generative AI Frameworks: Proficiency with generative AI libraries and frameworks such as Hugging Face Transformers, Lang Chain, OpenAI API, or similar platforms for building and deploying AI applications • Prompt Engineering and Optimization: Experience designing, testing, and optimizing prompts for various use cases including text generation, summarization, classification, and conversational AI applications • Vector Databases and Embeddings: Knowledge of vector similarity search, embedding models, and vector databases (Pinecone, We aviate, Chroma) for building retrieval-augmented generation (RAG) systems • AI Model Evaluation: Experience with evaluation methodologies for generative models including BLEU scores, ROUGE metrics, human evaluation frameworks, and bias detection techniques • Multi-modal AI Systems: Familiarity with multi-modal generative models combining text, images, and other data types, including experience with vision-language models and cross-modal applications • AI Safety and Alignment: Understanding of responsible AI practices including content filtering, bias mitigation, hallucination detection, and techniques for ensuring AI outputs align with business requirements and ethical guidelines
Posted 2 weeks ago
3.0 years
0 Lacs
Gurugram, Haryana, India
On-site
Job Title: Healthcare Analytics Specialist Experience Required - 3 To 5 Years Location-Gurugram(Hybrid) Position Summary The Analytics Specialist is responsible for driving insights & supporting decision-making by analyzing healthcare payer data, creating data pipelines, and managing complex analytics projects. This role involves collaborating with cross-functional teams (Operations, Product, IT, and external partners) to ensure robust data integration, reporting, and advanced analytics capabilities. The ideal candidate will have strong technical skills, payer domain expertise, and the ability to manage 3rd-party data sources effectively. Key Responsibilities Data Integration and ETL Pipelines Develop, maintain, and optimize end-to-end data pipelines, including ingestion, transformation, and loading of internal and external data sources. Collaborate with Operations to design scalable, secure, and high-performing data workflows. Implement best practices in data governance, version control, data security, and documentation. Analytics and Reporting Data Analysis: Analyze CPT-level data to identify trends, patterns, and insights relevant to healthcare services and payer rates. Build and maintain analytical models for cost, quality, and utilization metrics, leveraging tools such as Python, R, or SQL-based BI tools. Develop reports to communicate findings to stakeholders across the organization. 3rd-Party Data Management Ingest and preprocess multiple 3rd party data from multiple sources and transform it into unified structures for analytics and reporting Ensure compliance with transparency requirements and enable downstream analytics. Design automated workflows to update and validate data, working closely with external vendors and technical teams. Establish best practices for data quality checks (e.g., encounter completeness, claim-level validations) and troubleshooting. Quality Assurance and Compliance Ensure data quality by implementing validation checks, audits, and anomaly detection frameworks. Maintain compliance with HIPAA, HITECH, and other relevant healthcare regulations and data privacy requirements. Participate in internal and external audits of data processes. Continuous Improvement & Thought Leadership Stay current with industry trends, analytics tools, and regulatory changes affecting payer analytics. Identify opportunities to enhance existing data processes, adopt new technologies, and promote data-driven culture within the organization. Mentor junior analysts and share best practices in data analytics, reporting, and pipeline development. Required Qualifications Education & Experience Bachelor’s degree in health informatics, Data Science, Computer Science, Statistics, or a related field (master's degree a plus). 3-5+ years of experience in healthcare analytics, payer operations, or related fields. Technical Skills Data Integration & ETL: Proficiency in building data pipelines using tools like SQL, Python, R, or ETL platforms (e.g., Talend, Airflow, or Data Factory). Databases & Cloud: Experience working with relational databases (SQL Server, PostgreSQL) and cloud environments (AWS, Azure, GCP). BI & Visualization: Familiarity with BI tools (Tableau, Power BI, Looker) for dashboard creation and data storytelling. MRF, All Claims, & Definitive Healthcare Data: Hands-on experience (or strong familiarity) with healthcare transparency data sets, claims data ingestion strategies, and provider/facility-level data from 3rd-party sources like Definitive Healthcare. Healthcare Domain Expertise Strong understanding of claims data structures (UB-04, CMS-1500), coding systems (ICD, CPT, HCPCS), and payer processes. Knowledge of healthcare regulations (HIPAA, HITECH, transparency rules) and how they impact data sharing and management. Analytical & Problem-Solving Skills Proven ability to synthesize large datasets, pinpoint issues, and recommend data-driven solutions. Comfort with statistical analysis and predictive modeling using Python or R. Soft Skills Excellent communication and presentation skills, with the ability to convey technical concepts to non-technical stakeholders. Strong project management and organizational skills, with the ability to handle multiple tasks and meet deadlines. Collaborative mindset and willingness to work cross-functionally to achieve shared objectives. Preferred/Additional Qualifications Advanced degrees (MBA, MPH, MS in Analytics, or similar). Experience with healthcare cost transparency regulations and handling MRF data specifically for compliance. Familiarity with DataOps or DevOps practices to automate and streamline data pipelines. Certification in BI or data engineering (e.g., Microsoft Certified: Azure Data Engineer. Experience establishing data stewardship programs & leading data governance initiatives. Why Join Us? Impactful Work – Play a key role in leveraging payer data to reduce costs, improve quality, and shape population health strategies. Innovation – Collaborate on advanced analytics projects using state-of-the-art tools and platforms. Growth Opportunity – Be part of an expanding analytics team where you can lead initiatives, mentor others, and deepen your healthcare data expertise. Supportive Culture – Work in an environment that values open communication, knowledge sharing, and continuous learning. Powered by JazzHR llxBL5iYmF
Posted 2 weeks ago
1.0 - 3.0 years
1 - 4 Lacs
Chennai
Work from Office
Access Health Care Hiring Experienced - HCC Coders & QA Experience - 0.6 Months - 3 years Location - Chennai Specialty - HCC Certified only ( Any Certification ) Work From Office NOTICE Period Acceptable & ( Preferred Immediate Joiners ) Designation - Medical Coder / QA / QC Shift: Day shift Compensation: We offer highly competitive work environment with best in the business compensation package. Contact Name : Suhashini ( HR ) Contact Number : 9840064094 call and whatsapp suhashini@accesshealthcare.com
Posted 2 weeks ago
0 years
0 Lacs
Uttar Pradesh, India
On-site
Position Responsibilities – Thorough understanding of the contents of medical record in order to identify information to support coding. Basic knowledge of anatomy & physiology of human body and diseases in order to understand etiology, pathology, symptoms, signs, diagnostic studies, treatment modalities, and procedures to be coded. Basic understanding of claims form and reimbursement process. Abstracts pertinent information from patient medical records. Assigns ICD-10-CM, CPT/HCPCS codes, and modifiers. Utilizing CCI edits, LCD policies, CPT and Clinical guidelines while assigning codes. Reviews denials for coding lapses and suggests coding changes for corrective and preventive (root cause) action by DHT (denial handling team) team. Actively reviews denials and research to create claims scrubber edit which will prevent specific coding denials permanently. Notifies Coding Manager/Account Manager or designated individual when reports are incomplete, and code assignments are not straightforward or documentation is inadequate and updates relevant logs. Keeps self-updated of coding guidelines and federal reimbursement requirements, actively participates in and contributes to coding team presentations on Advance/Refresher Coding topics Abides by Standards of ethical coding as set forth by American Academy of Professional Coders (AAPC) and American Health Information Management Association (AHIMA) and adheres to official coding guidelines. Position Qualifications – Must be a graduate, preferably in Life Science, with basic training in medical transcription or medical coding, or coding certificate program with AAPC/AHIMA certification status (CIRCC/CPC/COC)/CCS) preferred. Must be ICD-10 certified.
Posted 2 weeks ago
1.0 - 6.0 years
10 - 14 Lacs
Kochi
Work from Office
Renai Medicity is looking for Senior Neuro Surgeon to join our dynamic team and embark on a rewarding career journeySpecializes in the surgical treatment of conditions affecting the brain, spinal cord, and nervesResponsibilities include evaluating patients, ordering and interpreting diagnostic tests, developing treatment plans, and performing surgeries.Prescribing medication and performing follow-up evaluations.Must have strong surgical skills, as well as a thorough understanding of anatomy, physiology, and medical technologies.
Posted 2 weeks ago
1.0 - 5.0 years
9 - 12 Lacs
Kochi
Work from Office
Renai Medicity is looking for Trauma Surgeon to join our dynamic team and embark on a rewarding career journeyA surgeon is a medical doctor who specializes in performing surgical procedures to treat injuries, diseases, and deformities through operative techniques. Surgeons undergo extensive training, typically completing medical school followed by a residency program focused on surgery. They possess advanced knowledge of human anatomy, physiology, and medical technology. Surgeons work in various specialties such as general surgery, orthopedic surgery, neurosurgery, cardiovascular surgery, and more. Their responsibilities include diagnosing patients, planning and performing surgical procedures, collaborating with other medical professionals, and providing post-operative care. Surgeons require excellent technical skills, decision-making abilities, and communication skills to effectively manage complex medical conditions and ensure the best possible outcomes for their patients.
Posted 2 weeks ago
2.0 - 7.0 years
7 - 11 Lacs
Hyderabad
Work from Office
Primary Responsibilities: Lead a team of 75-90 certified coders. Maintains staff by recruiting, selecting, orienting, and training employees; maintaining a safe, secure, and legal work environment; developing personal growth opportunities Performance Management Timeliness, Quality and Productivity metrics Planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards Maintains quality service by enforcing quality and customer service standards; analyzing and resolving quality and customer service problems; identifying trends; recommending system improvements Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications: Graduate in any discipline Experience in Performance Management, Project Management, Coaching, Supervision, Quality Management, Results Driven, Developing Budgets, Developing Standards, Foster Teamwork, Handles Pressure, Giving Feedback Proven ability to use Microsoft Office Products (Excel, PowerPoint etc) Proven ability to operate basic office equipment (copier and facsimile machine) Preferred Qualifications: Graduate of Life science Certified Professional Coder / Certified Coding Specialist with 2 years coding experience At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyoneof every race, gender, sexuality, age, location and incomedeserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes an enterprise priority reflected in our mission. #NJP
Posted 2 weeks ago
2.0 - 7.0 years
5 - 10 Lacs
Chennai
Work from Office
Primary Responsibilities: Lead a team of 25 – 30 certified coders. Maintains staff by orienting and training employees; maintains a safe, secure, and legal work environment Performance Management – Timeliness, Quality and Productivity metrics Planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards Maintains quality service by enforcing quality and customer service standards; analyzing and resolving quality and customer service problems; identifying trends; recommending system improvements Maintains professional and technical knowledge by attending educational workshops; reviewing professional publications; establishing personal networks; benchmarking state-of-the-art practices; participating in professional societies Drive employee engagement and retention activities by sharing company’s vision and goals, empowering employees on tasks as per their skill set, providing regular feedback etc. Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Required Qualifications: Graduate in any discipline Certified coder from AAP/AHIMA 2+ years of experience as Team leader or Assistant Manager Experience in handling a team of minimum 15 Experience from medical coding background only Experience in performance management, coaching, supervision, quality management, results driven, foster teamwork, handles pressure, giving feedback Proven ability to use Microsoft Office Products (Excel, PowerPoint etc.) Proven ability to operate basic office equipment (copier and facsimile machine) At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone – of every race, gender, sexuality, age, location and income – deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes – an enterprise priority reflected in our mission. #njp #SSCorp External Candidate Application Internal Employee Application
Posted 2 weeks ago
1.0 - 4.0 years
3 - 7 Lacs
Noida, Chennai, Bengaluru
Work from Office
Role Objective: The accounts receivable follow-up team in a healthcare organization is responsible for looking after denied claims and reopening them to receive maximum reimbursement from the insurance companies.Essential Duties and ResponsibilitiesFollow up with the payer to check on claim status. Identify denial reason and work on resolution. Save claim from getting written off by timely following up. Should have sound knowledge of working on Billing scrubbers and making edits. Work on Contractual adjustments & write off projects. Should have good Cash collected/Resolution Rate. should have calling skills, probing skills and denials understanding. Work in all shifts on a rotational basis. No Planned leaves for next 6 months. Qualifications: Graduate in any discipline from a recognized educational institute. Good analytical skills and proficiency with MS Word, Excel, and PowerPoint. Good communication Skills (both written & verbal) Skill Set: Candidate should be good in Denial Management. Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials. Ability to interact positively with team members, peer group and seniors r1rcm.com Facebook Location - Chennai,Noida,Bengaluru,Gurugram
Posted 2 weeks ago
8.0 - 13.0 years
2 - 6 Lacs
Noida
Work from Office
R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to make healthcare work better for all by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 16,000+ strong in India with presence in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Job Responsibilities: Identify, analyze, and manage all issues about claims edits and rejects Coordinate, assign, audit, and supervise work with all India BSO teams to ensure productivity standards and goals are consistently met. Review and analyze top edits and rejects with BSO global team every week. Identify the opportunities for edits and rejects that could be reduced Active participation in weekly calls; top edits and rejects review call with the onshore team Oversee monthly reporting, weekly DNFB, monthly performance deck, Supervise staff including performance management, training and development, workflow planning, hiring, and disciplinary actions. Implement and maintain department compliance with new and existing policies and procedures. Ensure timely completion of month-end duties and perform other duties as assigned. Continually evaluate claim processing business and make suggestions for improvement. Knowledgeable in end to end revenue cycle management Reliable and punctual in reporting for work and taking designated breaks. What You Should Have to Qualify 8+ years of background in claims edits and clearing house rejects aspects of revenue cycle management. Preference will be given if have hospital billing experience. 4+ years of management experience leading or supervising billers. Must possess strong working knowledge of CPT, ICD10, Denials, edits, rejects. Demonstrate ability in managing projects with multi-disciplinary teams, with exceptional relationship-building skills. Ability to effectively speak with providers, employees, and all levels of staff within the company. Practical work experience desired in client relations, implementation and support, and process planning and improvement. Proficient in Microsoft Office (Excel, Word, PowerPoint, Outlook). Strong work ethic and professional communication. Be organized, ahead of schedule, communicative, and accountable. In short, own your role entirely, while being open to critiques, suggestions, and new ideas. Strong attention to detail and keep a constant eye out for opportunities to improve efficiency. Be passionate about customer service. You love helping people, and you constantly strive to deliver great solutions. Have experience with hospital billing and Meditech software will be given preference. Ability to adapt to changing priorities and handle multiple tasks simultaneously. r1rcm.com Facebook
Posted 2 weeks ago
0.0 - 1.0 years
0 Lacs
Chennai, Tamil Nadu, India
On-site
Job Family Coding OP (India) Travel Required None Clearance Required None Responsibility Accurately transforms medical diagnoses and procedures into designated alphanumerical codes in ICD-10-CM , ICD-10-PCS codes, CPT and HCPCS codes. Ensure that the daily coding volumes for the team are turned around accurately within the specified Turnaround Time. Checking input volumes allotted by TL Coding reports as per client guidelines and coding guidelines by maintaining operational quality and productivity. Regular interaction with TL and getting feedbacks. This position requires that one performs well independently and in a collaborative manner with their entire coding team. Understands in detail the workflow, procedures and specific criteria for the assigned client. Ensures he/she meets the monthly target with above 95% accuracy consistently Attend the Weekly QA / Team meetings without fail and respond in two way communication with the Quality analyst/Team Lead. Shall understand and abide by the organizations’ information security policy and protect the confidentiality, integrity and availability of all information assets. Shall report incidents related to security of information to concerned authorities. Shall understand and abide by the organizations’ information security policy and protect the confidentiality, integrity and availability of all information assets. Shall report incidents related to security of information to concerned authorities. Minimum Qualification Any Life science, Paramedical Graduates and Post Graduates Minimum Experience And Skills Minimum Experience: 0-1 year experience. Basic Skill set: Strong ability to interpret medical records of the patients in different specialties. Ability to communicate, have excellent interpersonal, listening skills and organizational skills. Ability to work with speed and accuracy. Good analytic skills and expertise to be proficient in accurately coding medical records utilizing ICD-10-CM and CPT conventions especially 1 series to 6 series in Surgery Coding. What We Offer Guidehouse offers a comprehensive, total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace. About Guidehouse Guidehouse is an Equal Opportunity Employer–Protected Veterans, Individuals with Disabilities or any other basis protected by law, ordinance, or regulation. Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco. If you have visited our website for information about employment opportunities, or to apply for a position, and you require an accommodation, please contact Guidehouse Recruiting at 1-571-633-1711 or via email at RecruitingAccommodation@guidehouse.com. All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation. All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @guidehouse.com or guidehouse@myworkday.com. Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process. If any person or organization demands money related to a job opportunity with Guidehouse, please report the matter to Guidehouse’s Ethics Hotline. If you want to check the validity of correspondence you have received, please contact recruiting@guidehouse.com. Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicant’s dealings with unauthorized third parties. Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.
Posted 2 weeks ago
0 years
0 Lacs
Hyderabad, Telangana, India
On-site
R1 is a leading provider of technology-driven solutions that help hospitals and health systems to manage their financial systems and improve patients’ experience. We are the one company that combines the deep expertise of a global workforce of revenue cycle professionals with the industry's most advanced technology platform, encompassing sophisticated analytics, Al, intelligent automation and workflow orchestration. R1 is a place where we think boldly to create opportunities for everyone to innovate and grow. A place where we partner with purpose through transparency and inclusion. We are a global community of engineers, front-line associates, healthcare operators, and RCM experts that work together to go beyond for all those we serve. Because we know that all this adds up to something more, a place where we're all together better. R1 India is proud to be recognized amongst Top 25 Best Companies to Work For 2024, by the Great Place to Work Institute. This is our second consecutive recognition on this prestigious Best Workplaces list, building on the Top 50 recognition we achieved in 2023. Our focus on employee wellbeing and inclusion and diversity is demonstrated through prestigious recognitions with R1 India being ranked amongst Best in Healthcare, Top 100 Best Companies for Women by Avtar & Seramount, and amongst Top 10 Best Workplaces in Health & Wellness. We are committed to transform the healthcare industry with our innovative revenue cycle management services. Our goal is to ‘make healthcare work better for all’ by enabling efficiency for healthcare systems, hospitals, and physician practices. With over 30,000 employees globally, we are about 16,000+ strong in India with presence in Delhi NCR, Hyderabad, Bangalore, and Chennai. Our inclusive culture ensures that every employee feels valued, respected, and appreciated with a robust set of employee benefits and engagement activities. Designation: Assistant Operations Manager Reports to (level of category): Manager - Operations Role Objective Follow up is the most essential part in the RCM cycle. It is usually the last step in the cycle after cash posting. After Denial management (AR Follow up), again the cycle starts till the payment is made by the insurance company. Essential Duties And Responsibilities Establishes and assures compliance with departmental policies and procedures in conformance with corporate policies and procedures. Manages people and drives retention Analysis data to identify process gaps, prepare reports Performance management First level of escalation Work in all shifts on a rotational basis Need to be cost efficient with regards to processes, resource utilization and overall constant cost management Must operate utilizing aggressive operating metrics. Qualifications Graduate in any discipline from a recognized educational institute (Except B.Pharma, M.Pharma, Regular MBA, MCA B.Tech Freshers') Good analytical skills and proficiency with MS Word, Excel and Powerpoint (Typing speed of 30 WPM) Good communication Skills (both written & verbal) Skill Set Candidate should be good in Denial Management Candidate should have knowledge of Medicare, Medicaid & ICD & CPT codes used on Denials Ability to interact positively with team members, peer group and seniors. Subject matter expert in AR follow up Demonstrated ability to exceed performance targets Ability to effectively prioritize individual and team responsibilities Communicates well in front of groups, both large and small. Working in an evolving healthcare setting, we use our shared expertise to deliver innovative solutions. Our fast-growing team has opportunities to learn and grow through rewarding interactions, collaboration and the freedom to explore professional interests. Our associates are given valuable opportunities to contribute, to innovate and create meaningful work that makes an impact in the communities we serve around the world. We also offer a culture of excellence that drives customer success and improves patient care. We believe in giving back to the community and offer a competitive benefits package. To learn more, visit: r1rcm.com Visit us on Facebook
Posted 2 weeks ago
8.0 years
2 - 6 Lacs
Hyderābād
On-site
About Us: Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. Come Join Our Team! As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards. Help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus! Job Summary: We are currently seeking a skilled and experienced individual to lead our Medical Coding team as a US Healthcare Medical Manager, Coding. This role requires a deep understanding of medical coding practices, regulations, and industry standards within the US healthcare system. The ideal candidate will possess strong leadership abilities, exceptional organizational skills, and a commitment to maintaining high standards of accuracy and compliance. Essential Functions and Tasks: Team Leadership: Provide leadership and guidance to the medical coding team, including assigning tasks, setting goals, and conducting performance evaluations. Foster a positive work environment that encourages collaboration, innovation, and professional growth. Coding Operations: Oversee all aspects of the medical coding process, ensuring accuracy, completeness, and compliance with relevant coding guidelines and regulations (e.g., CPT, ICD-10, HCPCS). Implement best practices to optimize coding efficiency and productivity. Compliance: Stay informed about changes and updates in coding regulations, reimbursement policies, and healthcare compliance requirements. Ensure that coding practices align with applicable laws, regulations, and industry standards, including HIPAA and other privacy regulations. Training and Development: Provide ongoing training and education to coding staff to keep them updated on changes in coding guidelines, regulations, and best practices. Mentor team members and support their professional development goals. Collaboration: Work closely with other departments, such as revenue cycle management, clinical documentation improvement, and compliance, to ensure seamless integration of coding processes with overall revenue cycle operations. Collaborate with internal and external stakeholders to address coding-related issues and optimize revenue capture. Performance Analysis: Monitor coding metrics and key performance indicators to track team performance and identify opportunities for process improvement. Develop reports and presentations to communicate coding trends, challenges, and achievements to senior management. Education and Experience Requirements: Bachelor's degree in any related field. Master's degree preferred. Certified Coding Specialist (CCS) or Certified Professional Coder (CPC) certification required. Minimum of 8 years of experience in medical coding, with at least 3 years in a supervisory or managerial role. Knowledge, Skills, and Abilities: In-depth knowledge of CPT, ICD-10, HCPCS coding systems, as well as coding guidelines and regulations in the US healthcare industry. Strong leadership skills, with the ability to motivate and inspire team members to achieve high performance standards. Excellent communication and interpersonal skills, with the ability to collaborate effectively with diverse stakeholders. Proficiency in coding software and electronic health record (EHR) systems. Demonstrated experience in developing and implementing coding policies, procedures, and quality assurance programs. Experience with revenue cycle management processes and healthcare reimbursement methodologies. Familiarity with coding-related software tools and technology, such as encoders, grouper software, and computer-assisted coding (CAC) systems. Knowledge of healthcare compliance regulations, including HIPAA, HITECH, and Medicare billing rules. Compensation: Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons. This position is also eligible for a discretionary incentive bonus in accordance with company policies. Ventra Health: Equal Employment Opportunity (Applicable only in the US) Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions. Recruitment Agencies Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes. Solicitation of Payment Ventra Health does not solicit payment from our applicants and candidates for consideration or placement. Attention Candidates Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters. To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/. Statement of Accessibility Ventra Health is committed to making our digital experiences accessible to all users, regardless of ability or assistive technology preferences. We continually work to enhance the user experience through ongoing improvements and adherence to accessibility standards. Please review at https://ventrahealth.com/statement-of-accessibility/.
Posted 2 weeks ago
5.0 - 7.0 years
6 - 10 Lacs
Tumsar, Pune, Washim
Work from Office
Key Responsibilities: 1. Sales and Promotion: o Promote and sell the company's products to healthcare providers, including doctors, pharmacists, and hospital staff. o Develop and execute sales strategies to achieve or exceed sales targets. 2. Client Relationship Management: o Build and maintain strong relationships with key healthcare professionals and decision-makers. o Provide excellent customer service by addressing client queries and concerns promptly. 3. Product Knowledge: o Develop in-depth knowledge of the company's products and their applications. o Stay updated on competitor products, industry trends, and market dynamics. 4. Demonstrations and Presentations: o Conduct product demonstrations and educational presentations to healthcare professionals. o Highlight the benefits, features, and clinical effectiveness of the products. 5. Market Research: o Gather market intelligence and feedback from clients to identify opportunities and challenges. o Share insights with the marketing and product development teams to refine strategies. 6. Compliance and Reporting: o Ensure adherence to all regulatory and ethical standards in the medical sales process. o Maintain accurate records of sales activities, client interactions, and market feedback. o Prepare regular sales reports and forecasts for management review. Qualifications: Bachelors degree in Life Sciences, Pharmacy, Business, or a related field. Proven experience in sales or customer-facing roles is preferred, but freshers with a passion for sales are welcome to apply. Strong understanding of medical terminology and the healthcare industry. Excellent communication, negotiation, and interpersonal skills. Ability to work independently and manage time effectively. Preferred Skills: Familiarity with CRM software and sales tracking tools. Prior experience in the pharmaceutical or medical device industry is a plus. Strong presentation and public speaking abilities.
Posted 2 weeks ago
0 years
2 - 2 Lacs
Mohali
On-site
Job description Job description Job Summary: We are seeking a detail-oriented and motivated Junior Medical Coder to join our medical billing team. The ideal candidate will assist in reviewing, analyzing, and assigning appropriate medical codes (ICD-10, CPT, and HCPCS) for diagnoses, procedures, and services to ensure accurate billing and compliance with insurance guidelines. Key Responsibilities: Review clinical documentation to assign accurate medical codes for diagnoses, procedures, and services. Ensure coding is compliant with industry standards and company guidelines (ICD-10, CPT, HCPCS, etc.). Work with healthcare providers and billing staff to clarify documentation and resolve coding issues. Assist in charge entry and claims processing as needed. Stay current with updates to coding regulations, payer requirements, and industry best practices. Maintain confidentiality and security of patient data in accordance with HIPAA regulations. Support senior coders and billing staff with day-to-day tasks. Qualifications: High school diploma or equivalent required; associate degree or certification in medical coding is a plus. Certification from AAPC (e.g., CPC) or AHIMA (e.g., CCS, CCA) preferred or in progress. Basic knowledge of medical terminology, anatomy, and physiology. Familiarity with EHR systems and billing software (e.g., Epic, Kareo, AdvancedMD) is a plus. Strong attention to detail and ability to work independently and within a team. Good communication and organizational skills. Job Types: Full-time, Permanent Pay: ₹18,000.00 - ₹20,000.00 per month Schedule: Day shift Monday to Friday Night shift Work Location: In person
Posted 2 weeks ago
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