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0.0 - 3.0 years
2 - 6 Lacs
Bengaluru
Work from Office
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Primary Responsibilities: The Coder performs a variety of activities involving the coding of medical records as a mechanism for indexing medical information which is used for completion of statistics for hospital, regional and government planning and accurate hospital reimbursement Codes inpatient and/or outpatient records and identifies diagnoses and procedures daily according to the schedule set within the coding unit The Coder accurately assigns ICD-10 and/or CPT-4 codes in accordance with Coding Departmental guidelines maintaining no less than 95% accuracy in choice and sequencing of codes The Coder identifies and abstracts records consistently and accurately Consistently demonstrates time awareness: strives to meet deadlines; reduces non-essential interruptions to an absolute minimum Meets departmental productivity standards for coding and entering inpatient and/or outpatient records Participates in coding meetings and education conferences to maintain coding skills and accuracy Demonstrates willingness and flexibility in working additional hours or changing hours Demonstrates thorough understanding on how position impacts the department and hospital Demonstrates a good rapport and works to establish cooperative working relationships with all members of departmental and Hospital staff Attend conference calls as necessary to provide information relating to Coding 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 Certified Fresher or experience in medical coding or with any other experience Certified coder through AAPC or AHIMA Certifications accepted include CPC, CCS, CIC and COC Anyone All the candidates must have current coding certifications and must provide proof of certification with valid certification identification number during interview or offer process 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 1 month ago
5.0 - 10.0 years
3 - 7 Lacs
Noida
Work from Office
Primary Responsibilities: Identify appropriate assignment of ICD 10 CM and ICD 10 PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC / MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Abstract additional data elements during the Chart Review process when coding, as needed Adhere to the ethical standards of coding as established by AAPC and / or AHIMA Ability to code 1.5-2.5 charts per hour and meeting the standards for quality criteria Needs to constantly track and implement all the updates of AHA guidelines Provide documentation feedback to providers and query physicians when appropriate Maintain up to date Coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, etc. Participate in coding department meetings and educational events Review and maintain a record of charts coded, held, and / or missing Be an ideal team player who can work in a large group and provide inputs to the team for betterment of the team in terms of quality and productivity Under general supervision, organizes and prioritizes all work to ensure that records are coded and edits are resolved in a timeframe that will assure compliance with regulatory and client guidelines Adherence with confidentiality and maintains security of systems. Compliance with HIPAA policies and procedures for confidentiality of all patient records Demonstrates knowledge of security of systems and associated policies and procedures for maintaining the security of the data contained within the systems 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: Life Science or Allied Medicine Graduates Certification from AAPC or AHIMA (CIC certification preferred) 5+ years of Acute Care Inpatient medical coding experience (hospital, facility, etc.) Experience with working in a level I trauma center and / OR teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding ICD 10 (CM & PCS) and DRG 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 #NTRQ
Posted 1 month ago
0.0 - 3.0 years
4 - 7 Lacs
Mumbai
Work from Office
Primary Responsibilities: To be an effective participant in Class room training and clear the training assessments with 85% quality Consistently meet the targets set for MOCK charts Eligible employee will get confirmed as Junior Coder within a max of 6 months from the Joining Punctuality, Attendance and General Adherence to company policies, procedures and practices Strives to provide ideas to constantly improve the process Ensure adherence to external and internal quality and security standards (HIPPA/ISO/ISMS) Be an effective team player 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 #NTRQ Eligibility To apply to an internal job, employees must meet the following criteria: SG 22 can apply will move laterally Performance rating in the last common review cycle of Meets Expectations or higher Not be on any active CAP (Corrective Action Plan) or active disciplinary action Time in Role Guidelines Should have been in your current position for a minimum of 12 months, if you have not met the recommended minimum time in role, discuss your career interest with your manager and gain alignment prior to applying. And share the alignment email with respective recruiter while applying Required Qualifications: Any degree in Life Science or Bio-Science Any degree in Pharmacy or Pharmaceutical Sciences Any degree in Nursing or Allied Health Any degree in Medicine 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.
Posted 1 month ago
2.0 - 7.0 years
4 - 8 Lacs
Bengaluru
Work from Office
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Primary Responsibilities: Lead a team of 25-30 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 of handling HCC team (QRAO) for 2+ years as assistant manager or working as deputy manager 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) 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 1 month ago
5.0 - 10.0 years
3 - 7 Lacs
Hyderabad
Work from Office
Primary Responsibilities: Identify appropriate assignment of ICD 10 CM and ICD 10 PCS Codes for inpatient services provided in a hospital setting and understand their impact on the DRG with reference to CC / MCC, while adhering to the official coding guidelines and established client coding guidelines of the assigned facility Abstract additional data elements during the Chart Review process when coding, as needed Adhere to the ethical standards of coding as established by AAPC and / or AHIMA Ability to code 1.5-2.5 charts per hour and meeting the standards for quality criteria Needs to constantly track and implement all the updates of AHA guidelines Provide documentation feedback to providers and query physicians when appropriate Maintain up to date Coding knowledge by reviewing materials disseminated / recommended by the QM Manager, Coding Operations Managers, and Director of Coding / Quality Management, etc. Participate in coding department meetings and educational events Review and maintain a record of charts coded, held, and / or missing Be an ideal team player who can work in a large group and provide inputs to the team for betterment of the team in terms of quality and productivity Under general supervision, organizes and prioritizes all work to ensure that records are coded and edits are resolved in a timeframe that will assure compliance with regulatory and client guidelines Adherence with confidentiality and maintains security of systems. Compliance with HIPAA policies and procedures for confidentiality of all patient records Demonstrates knowledge of security of systems and associated policies and procedures for maintaining the security of the data contained within the systems 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: Life Science or Allied Medicine Graduates Certification from AAPC or AHIMA (CIC certification preferred) 5+ years of Acute Care Inpatient medical coding experience (hospital, facility, etc.) Experience with working in a level I trauma center and / OR teaching hospital with a mastery of complex procedures, major trauma ER encounters, cardiac catheterization, interventional radiology, orthopedic and neurology cases, and observation coding ICD 10 (CM & PCS) and DRG 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 1 month ago
1.0 - 6.0 years
2 - 7 Lacs
Chennai
Work from Office
Hi All interview Started For CODERS & QA and offer Relese also Started ED Facility 1 year Above , Denial coders , surgery coder, EM OP coder Location - Chennai, comibatore, pune ONLY WORK FROM OFFICE Certified Must NOTICE Period Acceptable Designation - Medical Coder / QA Shift: Day shift Available Timing from 10.30 am to 6.30 pm Monday to Saturday kowsalya 8122343331 WatsApp and call Send Updated Resume , Recent Photo with the Mentioned Details Your Interview Will Be Scheduled Name - Contact Number - Current Company - Experience - Certification - Take home salary - Expected salary - Certification Number - NOTICE PERIOD - Active Bond - Email ID - Kinldy share this to all friends who in need of jobs in Coding
Posted 1 month ago
0.0 - 2.0 years
2 - 2 Lacs
Ariyalur, Kumbakonam, Tiruchirapalli
Work from Office
Medical Coding is the process of converting Verbal Descriptions into numeric or alpha numeric by using ICD 10-CM, CPT && HCPCS. As per HIPAA rules healthcare providers need efficient Medical Coders. Qualification & Specifications : MBBS,BDS,BHMS,BAMS,BSMS,PHARMACYB.Sc/M.Sc (Life Sciences / Biology / Bio Chemistry / Micro Biology / Nursing / Bio Technology), B.P.T, B.E BIOMEDIAL, B.Tech (Biotechnology/Bio Chemistry). 2020 -2024 passed out Skills Required: * Candidates should have Good Communication & Analytical Skills and should be Good at Medical Terminology (Physiology & Anatomy). Role: To review US medical records Initial file review for identifying merits Subjective review and analysis to identify instances of negligence, factors contributing to it To review surgical procedures, pre and post-surgical care, nursing home negligence To prepare medical submissions To prepare the medical malpractice case Regards Kowshika 7200652461
Posted 1 month ago
1.0 - 4.0 years
1 - 3 Lacs
Hyderabad, Chennai, Bengaluru
Work from Office
Immediate Job Openings for EM Medical Coders @ Vee Healthtek Job Description: 1+ Years of Experience in EM Medical Coding. Specialty : EM Medical Coding Experience : 1 - 4 Years Designation : Medical Coder/ Sr Coder Certification: CPC/COC/CCS/CIC is Must Salary: 32K CTC Max Joining: Immediate Joiners only Location : Chennai/Bangalore/Trichy/Salem/Pune - WFO Interested Candidate can Call Immediately to 9443238706(Available on Whatsapp) or forward your profile to ramesh.m@veehealthtek.com Regards, Ramesh- HRD 9443238706 ramesh.m@veehealthtek.com Vee Healthtek
Posted 1 month ago
1.0 - 3.0 years
1 - 3 Lacs
Salem, Chennai, Tiruchirapalli
Work from Office
Immediate Job Openings for IVR Medical Coders @ Vee Healthtek Job Description: 1+ Years of Experience in IVR Medical Coding. Specialty : IVR Medical Coding Experience : 1 - 3 Years. Designation : Medical Coder/ Sr Coder Certification: CPC/COC/CCS/CIC is Must Salary: 35K CTC Max Joining: Immediate Joiners only Location : Chennai/Trichy/Salem - WFO Interested Candidate can Call Immediately to 9443238706 (Available on Whatsapp) or forward your profile to ramesh.m@veehealthtek.com Regards, Ramesh - HRD 9443238706 ramesh.m@veehealthtek.com Vee Healthtek
Posted 1 month ago
1.0 - 3.0 years
1 - 3 Lacs
Salem, Chennai, Tiruchirapalli
Work from Office
Immediate Job Openings for Radiology Medical Coders @ Vee Healthtek Job Description: 1+ Years of Experience in Radiology Medical Coding. Specialty : Radiology Medical Coding Experience : 1 - 3 Years. Designation : Medical Coder/ Sr Coder Certification: CPC/COC/CCS/CIC is Must Salary: 32K CTC Max (Not beyond that) Joining: Immediate Joiners only Location : Chennai/Trichy/Salem - WFO Interested Candidate can Call Immediately to 9443238706 (Available on Whatsapp) or forward your profile to ramesh.m@veehealthtek.com Regards, Ramesh - HRD 9443238706 ramesh.m@veehealthtek.com Vee Healthtek
Posted 1 month ago
1.0 - 5.0 years
1 - 5 Lacs
Chennai, Tiruchirapalli, Bengaluru
Work from Office
Immediate Job Openings for IP DRG Medical Coders @ Vee Healthtek Job Description: 1+ Years of Experience in IP DRG Medical Coding. Specialty : IP DRG Medical Coding Experience : 1 - 5 Years. Designation : Medical Coder/ Sr Coder/QA Certification: CPC/COC/CCS/CIC is Must Salary: 45K CTC Max Joining: Immediate Joiners only Location : Chennai/Bangalore/Trichy/Salem - WFO Interested Candidate can Call Immediately to 9443238706 (Available on Whatsapp) or forward your profile to ramesh.m@veehealthtek.com Regards, Ramesh - HRD 9443238706 ramesh.m@veehealthtek.com Vee Healthtek
Posted 1 month ago
1.0 - 5.0 years
1 - 5 Lacs
Hyderabad, Chennai, Bengaluru
Work from Office
Immediate Job Openings for Surgery Medical Coders @ Vee Healthtek Job Description: 1+ Years of Experience in Surgery Medical Coding. Specialty : Surgery Medical Coding Experience : 2 - 5 Years. Designation : Sr Coder/QA Certification: CPC/COC/CCS/CIC is Must Salary: 45K CTC Max Joining: Immediate Joiners only Location : Chennai/Bangalore/Hyderabad/Trichy/Salem/Pune - WFO Interested Candidate can Call Immediately to 9443238706 (Available on Whatsapp) or forward your profile to ramesh.m@veehealthtek.com Regards, Ramesh - HRD 9443238706 ramesh.m@veehealthtek.com Vee Healthtek
Posted 1 month ago
0 years
0 Lacs
Hyderabad, Telangana, India
On-site
Who We Are 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, amongst Top 50 Best Workplaces™ for Millennials, Top 50 for Women, Top 25 for Diversity and Inclusion and Top 10 for Health and 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 17,000+ 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 : Operations Manager Location: Hyderabad Reports to (level of category) : Senior Operations Manager 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. Day-to-day operations People Management (Work Allocation, On job support, Feedback & Team building) Performance Management (Productivity, Quality, One-On-One sessions, KRA, PIP) Reports (Internal and Client performance reports) Work allocation strategy CMS 1500 & UB04 AR experience is mandatory. Span of control - 80 to 100 Thorough knowledge of all AR scenarios and Denials Expertise in both Federal and Commercial payor mix Excellent interpersonal skills Should be capable to interact with US clients and manage escalations 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. 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 Show more Show less
Posted 1 month ago
1.0 - 3.0 years
0 - 0 Lacs
India
On-site
Role : Bench Sales Recruiter Location : Telecom Nagar, Gachibowli(On-site). Experience : 1-3 Years Job Roles and Responsibilities: 1. Marketing our Bench Consultants (H1B/OPT/CPT/F1/L1, GC & US CITIZEN) resumes with tier1 vendors/clients. 2. Developing new contacts with tier 1 vendors / Clients. 3. Understanding their resume skill set, keywords, tools and formatting it as required. 4. Searching Requirements on Job boards and submitting the resume. 5. Communicating with the consultants daily and update about submission and interviews. 6. Arranging interviews with tier one vendors or end clients. 7. Follow up with the candidate and client in each stage and until closing the candidate profile. 8. Strong experience in US Recruitment Cycle (Contract, Contract to Hire , Permanent) and terminology (Tax Terms, Employment Status, Time Zones etc.) 9. Clear understanding of the US Staffing processes/ Techniques, W2/ 1099/ Corp-to-Corp/ H1 Transfers 10.Negotiate rates with the Vendors/ Clients. Track the submissions and make regular follow-ups. 11. Meet or exceed sales targets on a consistent basis. Maintain accurate records of sales activities and client interactions. 12. Keep up-to-date with industry trends and developments. Benefits: 1. Best in industry, 2. Employee friendly workplace, 3. Perfect work-life balance, 4. Amazing incentive structure, 5. Provident Fund . Job Types: Full-time, Permanent Pay: ₹15,000.00 - ₹20,000.00 per month Benefits: Paid sick time Provident Fund Schedule: Fixed shift Monday to Friday Night shift US shift Experience: Bench Sales Recruiting : 1 year (Required) Language: English (Required) Work Location: In person
Posted 1 month ago
5.0 years
9 - 9 Lacs
Hyderābād
On-site
As a leading financial services and healthcare technology company based on revenue, SS&C is headquartered in Windsor, Connecticut, and has 27,000+ employees in 35 countries. Some 20,000 financial services and healthcare organizations, from the world's largest companies to small and mid-market firms, rely on SS&C for expertise, scale, and technology. Job Description Key Responsibilities: Pharmacy Benefits Domain Knowledge: Leverage knowledge of US Pharmacy standards, regulations, and practices (e.g., HIPAA, ICD-10, CPT codes, etc.) to ensure the system complies with industry-specific requirements and test as per the US Pharmacy Standards. Claims Testing: Testing pharmacy claims processes (adjudication, pricing, benefit configuration) while ensuring compliance with HIPAA, EDI (837/835/276/277), and ANSI X12 standards. It includes end-to-end claims lifecycle testing and validating ICD, CPT, and HCPCS codes. Verifying integrations with clearinghouses and payers. Test Planning and Execution: Develop detailed test plans, scenarios, and scripts to ensure comprehensive test coverage of business processes. Execute test cases manually or with automation tools. End-to-End Testing: Plan, design, and execute end-to-end test cases to verify the functionality and workflow of the system. Ensure complete traceability and coverage from requirement gathering to deployment. Defect Management: Identify, document, and track defects using defect management tools. Collaborate with development teams to resolve issues and ensure timely delivery of high-quality software. Collaboration with Cross-Functional Teams: Work closely with business analysts, developers, product managers, and other stakeholders to ensure that requirements are met and quality is maintained throughout the software development lifecycle. Automation: Able to work with test automation frameworks (e.g., Selenium, Gherkin, etc.) to create and execute automation test scripts. Required Qualifications: Experience: Minimum of 5 years of experience in Quality Engineering or Software Testing, particularly in the US Pharmacy Benefits domain, with a focus on Pharmacy Claims management. Pharmacy Healthcare Domain Expertise: Strong knowledge of US Pharmacy Healthcare industry standards, including pharmacy claims lifecycle, coding systems (ICD-10, CPT, HCPCS), and compliance (HIPAA, etc.). End-to-End Testing Experience: Proficiency in performing end-to-end testing, including functional, integration, and regression testing, from requirements through deployment. Testing Tools: Experience with test management tools and defect tracking systems. Automation Experience: Familiarity with test automation frameworks (e.g., Selenium, Gherkin, etc.) is a plus. Problem-Solving Skills: Ability to analyze complex business requirements and provide clear, actionable insights during the testing process. Attention to Detail: High attention to detail, ensuring accuracy and completeness of testing activities. Communication Skills: Strong written and verbal communication skills to effectively document test results, communicate defects, and collaborate with stakeholders. Agile Methodology: Experience working in Agile environments and participating in sprint planning, daily stand-ups, and sprint retrospectives. Unless explicitly requested or approached by SS&C Technologies, Inc. or any of its affiliated companies, the company will not accept unsolicited resumes from headhunters, recruitment agencies, or fee-based recruitment services. SS&C Technologies is an Equal Employment Opportunity employer and does not discriminate against any applicant for employment or employee on the basis of race, color, religious creed, gender, age, marital status, sexual orientation, national origin, disability, veteran status or any other classification protected by applicable discrimination laws.
Posted 1 month ago
1.0 years
0 - 0 Lacs
Visnagar
On-site
We're Hiring: Bench Sales Recruiter (Full-Time | Night Shift) Are you passionate about connecting top IT talent with the right opportunities? At Helix Tech IT Services, we don’t just fill positions, we build careers. Join us as a Bench Sales Recruiter and help candidates take the next big step while driving our mission forward. About Helix Tech IT Services Helix Tech IT Services is a fast-growing IT staffing and solutions company, dedicated to supporting CPT, OPT, H1B, GC, and citizen candidates with career placement, training, and professional growth. Roles & Responsibilities: Market and place bench candidates (US-based OPT/CPT/H1B/GC/US citizens) into suitable IT roles Develop and maintain relationships with implementation partners, vendors, and direct clients Coordinate interviews, follow-ups, and close deals efficiently Maintain accurate documentation of client and candidate interactions Collaborate with the internal training team to guide and prepare candidates Work in US time zone (EST/PST shift) Must-Have Skills: Minimum 1–2 years of experience in US Bench Sales Recruiting Excellent communication, negotiation, and interpersonal skills Proven experience with job portals like Dice, Monster, CareerBuilder, and LinkedIn Familiarity with US visa types and hiring processes Ability to work independently and under pressure What You Get: Competitive salary + attractive incentives Monthly performance bonuses Opportunity to work with a supportive, fast-paced, and growth-driven team Career advancement with internal upskilling & training options How to apply? Send your resume to: hr@helixtechinc.com Contact: +91 99988 34394 | www.helixtechinc.com Job Types: Full-time, Permanent Pay: ₹15,000.00 - ₹25,000.00 per month Schedule: Monday to Friday Night shift US shift Language: English (Required) Work Location: In person Application Deadline: 25/06/2025 Expected Start Date: 20/06/2025
Posted 1 month ago
1.0 - 6.0 years
1 - 4 Lacs
Chennai
Work from Office
Dear Aspirants, Warm Greetings!! We are hiring for the following details, Position: - AR Analyst - Charge Entry & QC - Payment Salary: Based on Performance & Experienced Exp : Min 1 year Required Joining: Immediate Joiner / Maximum 10 days NB: Freshers do not apply Work from office only (Direct Walkins Only) Monday to Friday ( 10 am to 6 Pm ) Everyday Contact person Vibha HR ( 9043585877 ) Interview time (10 Am to 6 Pm) Bring 2 updated resumes Refer( HR Name Vibha ) Mail Id : vibha@novigoservices.com Call / Whatsapp ( 9043585877 ) Refer HR Vibha Location : Chennai , Ekkattuthangal Warm Regards, HR Recruiter Vibha Novigo Integrated Services Pvt Ltd,Sai Sadhan, 1st Floor, TS # 125, North Phase,SIDCOIndustrial Estate, Ekkattuthangal, Chennai 32 Contact details:- HR Vibha Vibha @novigoservices.com Call / Whatsapp ( 9043585877 )
Posted 1 month ago
0.0 years
0 Lacs
Ambur, Tamil Nadu
On-site
PGT - Biology 3-5 Years of Experience in Teaching HSC Tamilnadu Samacheer Syllabus. Knowledge of NEET / CPT Exams Room Provide for outstation candidate Job Types: Full-time, Permanent, Part-time Pay: ₹15,000.00 - ₹20,000.00 per month Expected hours: 40 per week Benefits: Flexible schedule Leave encashment Schedule: Monday to Friday Weekend availability Ability to commute/relocate: Ambur, Tamil Nadu: Reliably commute or planning to relocate before starting work (Required) Work Location: In person Expected Start Date: 01/07/2025
Posted 1 month ago
0.0 - 5.0 years
0 Lacs
Chandigarh, Chandigarh
On-site
Job Description: AR Executive / Sr. AR Executive Job Title: AR Executive / Accounts Receivable Analyst Department: Account Receivable Reports To: AR Team Lead / AR Manager Location: Chandigarh, India Company Overview: ProBill RCM ProBill RCM is a dynamic and rapidly growing medical billing and revenue cycle management(RCM) company committed to optimizing financial performance for healthcare providers across various specialties. We leverage advanced technology and a team of meticulous experts to deliver accurate, compliant, and efficient billing solutions, ensuring our clients achieve maximum reimbursement and operational efficiency. We pride ourselves on our attention to detail, commitment to client success, and a collaborative work environment. Position Summary: The AR Executive / Accounts Receivable Analyst at ProBill RCM is a critical role responsible for-actively managing and resolving outstanding medical claims and patient balances. This position involves proactive follow-up with insurance companies, diligent denial management, and a keen eye for identifying trends and resolving payment discrepancies to maximize our clients'revenue capture. The ideal candidate will be a tenacious problem-solver with strong analytical skills and a deep understanding of the revenue cycle. Key Responsibilities: Claims Follow-up & Resolution: o Proactively review and manage aging reports to identify and follow up on unpaid and underpaid claims with insurance companies (commercial, Medicare, Medicaid, Workers' Compensation, VA). o Communicate directly with insurance payers via phone, payer portals, and written correspondence to ascertain claim status, resolve payment issues, and expedite reimbursement. Denial Management: o Analyze denied claims to determine the root cause of denial (e.g., coding errors, medical necessity, eligibility issues, missing information). o Prepare and submit appeals with supporting documentation, ensuringcompliance with payer-specific guidelines and timeframes. o Track denial trends and provide feedback to internal teams (e.g., Charge Entry, Coding) or clients to prevent future denials. Accounts Receivable Analysis: o Identify and analyze trends in outstanding accounts, underpayments, and denials to recommend process improvements. o Ensure proper posting of payments, adjustments, and write-offs. o Collaborate with the payment posting team to reconcile accounts. Patient Accounts & Collections: o Address patient account inquiries related to balances and Explanation of Benefits(EOBs). o Assist in setting up payment plans or resolving patient collection issues as per client policies. Documentation & Reporting: o Maintain accurate and detailed notes in the practice management systemregarding all follow-up actions and communications. o Generate and interpret AR reports to assess performance and identify areas for improvement. Compliance & Knowledge: o Stay current with changes in billing regulations, payer policies, and industry best practices. o Ensure all AR activities comply with HIPAA and other relevant healthcareregulations. Qualifications: Education: o High School Diploma or equivalent required. o Bachelor's degree in healthcare administration, finance, or a related field preferred. Experience: o 2-5 years of direct experience in Accounts Receivable, Medical Billing, or Revenue Cycle Management, with a strong focus on insurance follow-up and denial management. o Experience with various insurance types (commercial, Medicare, Medicaid) inessential. o Prior experience in a multi-specialty RCM environment is a plus. Skills & Knowledge: o Strong understanding of the entire revenue cycle process. o In-depth knowledge of CPT, ICD-10-CM, and HCPCS coding, and medical terminology. o Proficiency in interpreting Explanation of Benefits (EOBs), Electronic Remittance Advices (ERAs), and denial codes. o Exceptional analytical and problem-solving skills to investigate and resolve complex billing issues. o Strong communication skills (verbal and written English) for effective interaction with insurance payers, clients, and internal teams. o Proficiency with practice management systems (PMS) and electronic health record (EHR) systems. o Ability to work independently and collaboratively in a team-oriented, high- volume environment. o Excellent organizational skills and attention to detail. o Proficiency in Microsoft Office Suite, especially Excel, for data analysis and reporting. What ProBill RCM Offers: Competitive salary and performance-based incentives. Opportunities for professional growth and skill development within a rapidly expanding company. A collaborative, supportive, and dynamic work environment. The chance to significantly impact the financial success of healthcare providers. To Apply: Interested candidates are invited to submit their resume and a brief cover letter outlining their relevant experience and why they are a good fit for this role to hr@probillrcm.com Job Type: Full-time Benefits: Health insurance Leave encashment Paid sick time Paid time off Schedule: Day shift Monday to Friday Rotational shift Work Location: In person Speak with the employer +91 7717290606
Posted 1 month ago
3.0 years
0 Lacs
Chennai, Tamil Nadu
Remote
E&M Medical Coder (IP and ED) Experience: Minimum 3 years of relevant coding experience post CPC or CCS certification (mandatory) . Certifications: CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) – Only these certifications will be considered. Location: Kochi / Chennai / Banglore/ Hyderabad / Noida / (Hybrid) Working Hours: 9:00 AM – 6:00 PM (Willingness to extend as per requirement) Salary: 10LPA to ₹12 LPA Qualification : Any Graduation preferably in Science Domain. NB. Training period of first 3 months will be held at Chennai location. Responsibilities: Review and assign accurate CPT codes to E&M cases, including ED Facility and IP EM. Ensure coding quality and exceed productivity standards as per company norms. Participate in coding team discussions, audits, and continuous improvement initiatives. Stay current on industry updates, guidelines, and internal coding policies. Coordinate effectively with the onshore team when required. Requirements Experience: Minimum 3 years of relevant coding experience post CPC or CCS certification (mandatory). Certifications: CPC (Certified Professional Coder) or CCS (Certified Coding Specialist) – Only these certifications will be considered. Experience on payer side is a strong advantage. Skills: Strong analytical and coding skills in CPT for E&M cases. Excellent verbal and written communication skills. Ability to interact confidently with onshore teams. Job Types: Full-time, Permanent Pay: ₹50,000.00 - ₹100,000.00 per month Benefits: Health insurance Provident Fund Work from home Schedule: Day shift Monday to Friday Morning shift Ability to commute/relocate: Chennai, Tamil Nadu: Reliably commute or planning to relocate before starting work (Required) Application Question(s): Do you have Strong analytical and coding skills in CPT for E&M cases ? Education: Bachelor's (Required) Experience: Coding experience post CPC or CCS : 3 years (Preferred) Language: English (Required) License/Certification: CPC (Certified Professional Coder) (Required) CCS (Certified Coding Specialist) (Required) Work Location: In person
Posted 1 month ago
1.0 - 5.0 years
0 Lacs
Noida, Uttar Pradesh, India
On-site
About the company: Performship.com is fastest growing ad-agency. We believe in deliver high quality business services from Tech solutions to Digital Marketing. Performship has been associated with over 100 companies worldwide and is joined by more than 200 active and result oriented publishers. To deliver the best results, we attract and develop the best talent on board by creating opportunities that empower and motivate our clients. We deliver profitable growth for online businesses. Responsibility: Onboard new affiliate partners and manage existing vendors. Forming/negotiating strategic alliances with new and existing online partners. Acquiring publishers for Performance Activities and Branding. Handling Publisher Engagement and Retention. Identifying ways through comprehensive market research to improve the performance delivery Improving client expectations and experiences Desired Skills: • The ideal candidate should have a minimum of 1-5 years of prior experience working with ad networks and mobile ad networks. • Should have managed sales for large-scale campaigns, such as CPI, CPR, CPL, CPS, CPT, CPA • Sound knowledge of tracking tools. • Should know the integration process. • Knowledge of attribution platforms, Offer 18, Appsflyer, Branch, Singular, Adjust, etc. • Excellent verbal & written communication skills. Remuneration: • Best in Industry. Location: Noida (In-Office) Show more Show less
Posted 1 month ago
1.0 - 3.0 years
0 Lacs
Chennai, Tamil Nadu, India
On-site
Boost your career prospects as a Medical Coder with Medical Billing Wholesalers, one of the fastest-growing offshore medical billing companies. At MBW, normal is truly boring and provide you exciting opportunities to learn and work with your customer to grow your career. Our remuneration is in line with industry standards along with attractive benefits. Job Description Review medical charts under the diagnosis and procedure to ascribe the related CPT and ICD-10 Ensure that you assign codes based on coding and customer guidelines Proficient coding of outpatient/Inpatient charts across a variety of specialties with over 97% accuracy and as per the turnaround time Strong knowledge in CPT and ICD-10 guidelines Assign correct codes and perform edits as per correct coding initiative Work as part of a team and achieve the team quality and productivity standards Support billers and AR analysts. Participate in ongoing local chapter meetings of AAPC and other industry bodies Understand the causes of claim denials and continually improve coding standards Document feedback on errors in clinical documentation at a facility and physician-specific levels Candidate Profile Should have 1 to 3 years of experience in medical coding Experience in coding specialty – IPDRG Certifications desired CPC/COC/CCS from AAPC/ AHIMA Non-certified Coders are also eligible Knowledge of the US healthcare industry is desired Good knowledge of client-specific process rules and regulatory requirements Show more Show less
Posted 1 month ago
10.0 years
0 Lacs
Greater Kolkata Area
On-site
Role We are seeking an experienced Data Modeler/Lead with deep expertise in health plan data models and enterprise data warehousing to drive our healthcare analytics and reporting initiatives. The candidate should have hands-on experience with modern data platforms and a strong understanding of healthcare industry data the Role : The candidate will be responsible for leading data modeling initiatives and ensuring compliance with healthcare regulations while collaborating with various stakeholders to translate business requirements into technical : Data Architecture & Modeling Design and implement comprehensive data models for health plan operations, including member enrollment, claims processing, provider networks, and medical management. Develop logical and physical data models that support analytical and regulatory reporting requirements (HEDIS, Stars, MLR, risk adjustment). Create and maintain data lineage documentation and data dictionaries for healthcare datasets. Establish data modeling standards and best practices across the organization. Technical Leadership Lead data warehousing initiatives using modern platforms like Databricks or traditional ETL tools like Informatica. Architect scalable data solutions that handle large volumes of healthcare transactional data. Collaborate with data engineers to optimize data pipelines and ensure data quality. Healthcare Domain Expertise Apply deep knowledge of health plan operations, medical coding (ICD-10, CPT, HCPCS), and healthcare data standards (HL7, FHIR, X12 EDI). Design data models that support analytical, reporting and AI/ML needs. Ensure compliance with healthcare regulations including HIPAA/PHI, and state insurance regulations. Partner with business stakeholders to translate healthcare business requirements into technical data solutions. Data Governance & Quality Implement data governance frameworks specific to healthcare data privacy and security requirements. Establish data quality monitoring and validation processes for critical health plan metrics. Lead efforts to standardize healthcare data definitions across multiple systems and data sources. Required Qualifications Skills 10+ years of experience in data modeling with at least 4 years focused on healthcare/health plan data. Expert-level proficiency in dimensional modeling, data vault methodology, or other enterprise data modeling approaches. Hands-on experience with Informatica PowerCenter/IICS or Databricks platform for large-scale data processing. Strong SQL skills and experience with Oracle Exadata and cloud data warehouses (Databricks). Proficiency with data modeling tools (Hackolade, ERwin, or similar). Healthcare Industry Knowledge Deep understanding of health plan data structures including claims, eligibility, provider data, and pharmacy data. Experience with healthcare data standards and medical coding systems. Knowledge of regulatory reporting requirements (HEDIS, Medicare Stars, MLR reporting, risk adjustment). Familiarity with healthcare interoperability standards (HL7 FHIR, X12 EDI). Leadership & Communication Proven track record of leading data modeling projects in complex healthcare environments. Strong analytical and problem-solving skills with ability to work with ambiguous requirements. Excellent communication skills with ability to explain technical concepts to business stakeholders. Experience mentoring team members and establishing technical standards. Preferred Qualifications Experience with Medicare Advantage, Medicaid, or Commercial health plan operations. Cloud platform certifications (AWS, Azure, or GCP). Experience with real-time data streaming and modern data lake architectures. Knowledge of machine learning applications in healthcare analytics. Previous experience in a lead or architect role within healthcare organizations. (ref:hirist.tech) Show more Show less
Posted 1 month ago
1.0 - 6.0 years
42 - 108 Lacs
Ameerpet
Work from Office
Title: Bench Sales Recruiter Location: Onsite , Somajiguda Experience Level: 6 months to 7 Years Contact: +91 78158 82181 - Aditya E- sukesh@cogentcube.com Note: Incentives will be credited in 15 days Food will be provided in the office Food allowance Annual bonus
Posted 1 month ago
0.0 - 5.0 years
3 - 7 Lacs
Noida
Work from Office
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. Role & responsibilities Primary Responsibilities Be able to implement all the updates of AMA guidelines, AHA guidelines, and CMS guidelines Be able to review and analyse medical records and add/modify CPT codes for minor surgical procedures, vaccines, and laboratory CPT codes as per documentation Be able to extract and code various screening CPT codes and HCPCS codes from the documentation Be able to check NCCI edits and LCD & NCD coverage determinations and modify ICD-10-CM codes, CPT codes, and modifiers accordingly Be an ideal team player who can work in a large group and provide inputs to the team for betterment of the team in terms of quality and productivity Under general supervision, organizes and prioritizes all work to ensure that records are coded, and edits are resolved in a timeframe that will assure compliance with regulatory and client guidelines Adherence with confidentiality and maintains security of systems Compliance with HIPAA policies and procedures for confidentiality of all patient records 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#NTRQ Preferred candidate profile Graduate Certified coder through AAPC or AHIMA Certifications accepted include CPC, CCS, CIC and COC - Anyone Current coding certifications and must provide proof of certification with valid certification identification number during interview or Offer process Sound knowledge in Medical Terminology, Human Anatomy and Physiology Knowledge of security of systems and associated policies and procedures for maintaining the security of the data contained within the systems Basic understanding of the ED/EM levels based on MDM and appending modifiers to CPT codes as per NCCI edits and CPT guidelines Proficient in ICD-10-CM, CPT, and HCPCS guidelines
Posted 1 month ago
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