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2.0 - 6.0 years
0 Lacs
thrissur, kerala
On-site
As an SME in Denial Management with 2-3 years of experience, you will be a part of Zapare Technologies Pvt. Ltd., a leading provider of Revenue Cycle Management (RCM) solutions for the US Healthcare industry. Your role will involve analyzing, managing, and resolving denied insurance claims to enhance collections and optimize revenue cycles for clients. Your main responsibilities will include developing and maintaining denial logs to identify trends, working with denial reason codes to take appropriate actions, and ensuring compliance with HIPAA, CMS guidelines, and coding standards. You will also manage the appeals process by understanding appeal processes and SOPs, preparing and submitting appeals with accurate documentation, and monitoring deadlines for timely submissions. The ideal candidate will possess a strong understanding of the US healthcare billing cycle, hands-on experience with EMR/EHR systems, in-depth knowledge of billing regulations, coding standards, and compliance frameworks. If you are passionate about healthcare revenue management and proficient in resolving complex denials, we encourage you to apply and be a part of the Zapare team. #Hiring #DenialManagement #RCM #HealthcareJobs #MedicalBilling #RevenueCycleManagement #ZapareTechnologies #CareerOpportunity,
Posted 1 week ago
2.0 - 6.0 years
0 Lacs
chennai, tamil nadu
On-site
As a Medical Coding Auditor specializing in ED & E/M coding, you will be responsible for reviewing medical charts, accurately assigning CPT and ICD-10 codes, ensuring compliance, and providing support to billing teams. Your in-depth knowledge of CPT and ICD-10 guidelines, coupled with high accuracy and timeliness, will be crucial in this role. Collaboration with the team is essential to meet quality standards and drive continuous improvement in coding processes. Your attention to detail and commitment to precision will contribute to the overall efficiency and effectiveness of our coding operations. Join our team to make a meaningful impact in healthcare coding and ensure the delivery of high-quality patient care.,
Posted 1 week ago
8.0 years
0 Lacs
Hyderabad, Telangana, India
On-site
Job Description Identify, analyze, and manage all issues about accounts receivable and member service inquiries. Coordinate, assign, audit, and supervise work with all India BSO teams to ensure productivity standards and goals are consistently met. Review and analyze past-due receivables with BSO global team every week. Monitor cash inflow and identify the roadblock which hindering the cash and highlight the same to the leadership team Active participation in weekly AR calls; denial review call with onshore team Oversee monthly A/R reporting, weekly ATB, 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 AR operations and make suggestions for improvement. Knowledgeable in revenue cycle management Reliable and punctual in reporting for work and taking designated breaks. Required Skillset 8+ years of background in AR and denial management aspects of revenue cycle management. Preference will be given if have hospital AR experience. 2+ years of People Management experience leading or supervising billers. Must possess strong working knowledge of CPT, ICD10, Denials, Appeals, & Correspondence, AR and Denial Management . 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. 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. 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 1 week ago
2.0 - 7.0 years
3 - 8 Lacs
Chennai
Work from Office
Minimum 2+ Years of Experience in ED Professional Both Certified & Non certified Can apply Mode of Interview - Virtual & Walk In Looking for Immediate joiner preferred Salary - Best in Industry Work Location - Chennai Regards, Krish Hr 9342780488
Posted 1 week ago
2.0 - 3.0 years
0 Lacs
Tamil Nadu, India
On-site
Job Purpose The Insurance Verification Representative II is responsible for obtaining and providing accurate and complete data input for precertification/preauthorization from insurance companies Duties And Responsibilities Work effectively with insurance companies to obtain pre-certification/authorization for services Place calls to various health plans to obtain appropriate precertification prior to the patient`s appointment Ability to understand/interpret documented clinical information and relay pertinent medical/clinical information to the insurance company Fax to pre-certification request form to insurance company Maintain files and security of confidential information utilizing host system to scan and input data as per established procedures Verify medical insurance information and documents in scheduling/registration modules Review claim denials and rejections Accurately enter and update patient data, and other general data, into the computer system Patient intake; insurance verification, notification of copays/patient liability and confirmation of demographics Maintain account work progress, including but not limited to updating authorization logs, account referral in EMR, authorization paperwork and issue reports Demonstrate knowledge of varied managed care insurance and regulatory guidelines Meet and maintain daily productivity/quality standards established in departmental policies Use the MPower workflow system, client host system and other tools available to collect payments and resolve accounts Adhere to the policies and procedures established for the client/team Communicate effectively with physician offices and patients Place outbound call to patients with precertification notification Work independently from assigned work queues Maintain confidentiality at all times Maintain a professional attitude Other duties as assigned by the management team Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards Qualifications High school diploma or equivalent required Medical terminology knowledge required Minimum of 2-3 years of healthcare or physician's office related experience in obtaining and handling pre-authorizations Proficiency with MS Office. Must have basic Excel skillset Experience with GE Centricity, EPIC PB, Allscripts, Cerner, preferred Extensive knowledge of individual payor websites, including eviCore, Navinet and Novitasphere Knowledge of Medical Terminology, CPT Codes, Modifiers and Diagnosis Codes Ability to work well individually and in a team environment Strong organizational and task prioritization skills Strong communication skills/oral and written Working Conditions Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear. Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress. Work Environment: The noise level in the work environment is usually minimal. Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
Posted 1 week ago
0.0 - 5.0 years
2 - 5 Lacs
Chennai
Work from Office
Hi All Access Health Care Hiring HCC Coders Experience - 0.6m+ yrs of exp Location - Chennai Specialty - HCC Certified only Work From Office Immediate Joiners Preferred NOTICE Period Acceptable Designation - Medical Coder / QA / QC Shift: Day shift Compensation: We offer highly competitive work environment with best in the business compensation package. Contact Name : Hashrithaa ( HR ) Contact Number : 9894654083 hashrithaa.b@accesshealthcare.com For any other queries kindly reach out & drop Your Resume On - Call And discuss for interview schedule and process 9894654083 Call/Whatsapp alone
Posted 1 week ago
1.0 - 5.0 years
3 - 5 Lacs
Chennai, Bengaluru
Work from Office
About Client Hiring for one of the most prestigious multinational corporations Job Title : Certified Multi Specialty Denial Coders Qualification : Any Graduate and Above Relevant Experience : 1 to 3 Years Must Have Skills : 1. Certification in medical coding (CPC, CCS, or equivalent). 2. Hands-on experience with denial analysis across multiple specialties like cardiology, orthopedics, neurology, etc. 3. Strong knowledge of modifiers, coding edits, and payer-specific requirements. 4. Good communication skills and detail-oriented approach. Good Have Skills : Certification in medical coding (CPC, CCS, or equivalent). Roles and Responsibilities : 1. Review and analyze denied claims across multiple specialties. 2. Identify root causes for denials and take corrective coding actions. 3. Collaborate with the denial management and billing teams to ensure timely resubmission of claims. 4. Maintain coding accuracy and adherence to payer-specific guidelines. 5. Utilize coding systems such as ICD-10-CM, CPT, and HCPCS effectively. 6. Provide feedback and input for denial prevention strategies. 7. Ensure coding compliance as per regulatory and client standards. Location : Bangalore, Chennai CTC Range : 3 5.4 LPA (Lakhs Per Annum) Notice Period : Immediate Mode of Interview : Virtual Shift Timing : Night Shift Mode of Work : Work From Office -- Thanks & Regards, Chaitanya HR Analyst- TA-Delivery Black and White Business Solutions Pvt Ltd Bangalore, Karnataka, INDIA. Direct Number: 080-67432445 | WhatsApp @ 8431371654 chaitanya.d@blackwhite.in | www.blackwhite.in *******DO REFER YOUR FRIENDS / FAMILY*******
Posted 1 week ago
1.0 - 6.0 years
2 - 7 Lacs
Chennai
Work from Office
Hi All Access Health Care Hiring HCC Coders Experience - 2 year - 20 years Location - Chennai Specialty - HCC Certified only Work From Office NOTICE Period Acceptable Designation - Medical Coder / QA / QC Shift: Day shift Compensation: We offer highly competitive work environment with best in the business compensation package. Contact Name : Preethi ( HR ) Contact Number : 8072406288 whatsapp alone preethi.b9@accesshealthcare.com For any other queries kindly reach out & drop Your Resume On - Call And discuss for interview schedule and process 8072406288 whatsapp alone Send Updated Resume , Recent Photo ,Aadhar with the Mentioned Details Your Interview Will Be Scheduled Rec Id - Needed to be done in Access Health Care Job App ( Find In Play store ) Name - Contact Number - Current Company - Experience - Location - Work Location - Applying For WFH/ WFO - Certification - Take home salary - Expected salary - Certification Number - Certification Number - NOTICE PERIOD - Active Bond - Email ID - kindly join our watsapp group for updates - https://chat.whatsapp.com/Ko1y1J7gLo43WGFFfRRAR2?mode=r_t
Posted 1 week ago
1.0 - 6.0 years
2 - 7 Lacs
Hyderabad
Work from Office
We are hiring a Healthcare Recruiter with minimum of 1-5 years of experience for Workforce solutions. Job Responsibilities: As a Healthcare Recruiter, you will be responsible for the following duties: As a Healthcare Recruiter, your day-to-day activities will be working on the Healthcare Requirements of our clients and sourcing candidates from various job portals and networking websites. Perform searches for qualified candidates according to relevant job criteria, using computer databases, networking, internet recruiting resources, cold calls, media, and referrals. Leverage various job portals e.g., Dice, Monster, Career Builder, indeed, etc. Must have an excellent understanding of Healthcare, Hospitals, Medical and other institutions in medical fields. Engage with potential candidates as per client requirements, including skills, education, experience, and competency. Source and Screen resume for the open position of healthcare role assigned by TL/Manager. Understand job profiles and schedule interviews with clients, accordingly, need to recruit Registered Nurses, Licensed Practitioner Nurses, Medical Assistants, Physicians, etc. Making calls to the candidates and performing daily tasks like Screening and scheduling interviews. Regularly update the internal tools and adhere to the company policies and practices while hiring. Communicate employer information and benefits during the screening process with candidates. Required Skills: 1- 5 yrs experience in US Staffing Recruitment is Mandatory Candidates from the US Staffing industry with Hands on experience in sourcing and End to End Recruitment experiences. Ability to demonstrate Full Recruiting Lifecycle (gathering requirements, candidate prospecting, candidate screening, Negotiations, candidate submission, follow-up, Interview & On Boarding, etc.) Good command of verbal and written communication skills. Excellent Negotiation skills. Good in Relationship management with clients/vendors and consultants. Excellent analytical, presentation, and interpersonal skills. Should be highly adaptable to new technologies and business environments. Go-getter attitude. Team player. Interested candidates can reach us syed.cb@cielhr.com | 9394368397
Posted 1 week ago
1.0 - 6.0 years
2 - 4 Lacs
Karjat
Work from Office
We are looking for a skilled OT Technician to join our team at Raigad Hospital and Research Centre. The ideal candidate will have 1-6 years of experience in the field. Roles and Responsibility Assist surgeons during surgical procedures and ensure patient safety. Prepare and maintain operating room equipment and instruments for surgery. Monitor patient vital signs and respond to emergencies. Maintain accurate records of patient information and medical history. Collaborate with other healthcare professionals to provide comprehensive care. Participate in ongoing education and training to stay updated on latest techniques and technologies. Job Requirements Strong knowledge of medical terminology and anatomy. Ability to work effectively in a fast-paced environment and prioritize tasks. Excellent communication and interpersonal skills. Ability to maintain confidentiality and handle sensitive information. Familiarity with hospital policies and procedures. Commitment to delivering high-quality patient care and services.
Posted 1 week ago
2.0 - 4.0 years
2 - 5 Lacs
Chennai
Work from Office
We are looking for a skilled Senior Coder with 2-4 years of experience to join our team in Chennai. The ideal candidate will have a strong background in coding and analytics, with excellent problem-solving skills. Roles and Responsibility Analyze medical records and assign accurate codes for diagnoses and procedures. Review and validate coding quality for accuracy and compliance. Develop and implement coding standards and guidelines. Collaborate with healthcare professionals to clarify coding discrepancies. Conduct audits to ensure coding compliance with regulations. Provide training and support to junior coders on coding best practices. Job Strong knowledge of coding principles and regulations. Excellent analytical and problem-solving skills. Ability to work accurately and efficiently in a fast-paced environment. Effective communication and collaboration skills. Strong attention to detail and organizational skills. Ability to maintain confidentiality and handle sensitive information. Experience working with CRM/IT Enabled Services/BPO industry. Company nameOmega Healthcare Management Services Pvt. Ltd. Reference number1376745.
Posted 1 week ago
0.0 - 1.0 years
0 - 1 Lacs
Hyderabad
Work from Office
Responsibilities: We want to hire an article or an inter in our CA Firm
Posted 1 week ago
1.0 years
0 Lacs
Chennai, Tamil Nadu, 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, 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: Assistant Operations Manager Role Objective: The role objective of a Outpatient Coding (HCC Coding) Assistant Operations Manager is to oversee and ensure accurate coding of Outpatient Facility medical records, maintain compliance with coding guidelines and regulatory requirements, and provide guidance and support to the coding team to achieve operational efficiency and quality standards. Essential Duties and Responsibilities: As a Team Leader: Leading and managing the HCC coding team, including allocating inventory, monitoring performance, and ensuring adherence to deadlines. Quality Assurance: Performing coding audits to ensure accuracy, compliance with coding standards (e.g., ICD-10-CM and CPT), and adherence to regulatory guidelines. Training and Mentorship: Providing training, guidance, and support to team members to enhance their skills and address coding-related queries. Compliance Oversight: Ensuring coding practices meet organizational policies, payer requirements, and federal regulations. Collaboration: Working with clinical staff, billing teams, and management to resolve discrepancies, clarify documentation, and optimize reimbursement processes. Reporting: Preparing and presenting reports on team performance, productivity, and quality metrics for leadership. Process Improvement: Identifying areas for process improvement and implementing strategies to enhance efficiency and accuracy in coding workflows. Required Skills Candidate must have 1 year experience working in HCC Coding & 8+ years of Multi-Specialty Coding experience Minimum of 2-3 years of experience in People Management role and ability to handle a team of 20+ coders. Certification & Education: Any certification from AAPC or AHIMA (currently active )and Any Bachler’s degree in education Excellent process knowledge and domain understanding relating to Outpatient Facility coding as per R1 standard. Ability to co-ordinate multiple projects and initiative simultaneously Self-driven, Excellent personal and interpersonal skills, active listener, and excellent communication skills Ability to manage day-to-day production related activities Good analytical and process improvement skills Ability to drive action plans and strategies. Adaptive and should have learning agility
Posted 1 week ago
3.0 years
0 Lacs
Hyderabad, Telangana, India
On-site
About The Role We are seeking a motivated and detail-oriented Mid-Level Data Engineer with 2–3 years of experience in designing, developing, and optimizing data pipelines within the healthcare domain. The ideal candidate will have hands-on experience with Databricks , strong SQL skills, and a solid understanding of healthcare data standards (e.g., HL7, EDI X12 – 837/835, HCC, CPT/ICD codes). Key Responsibilities Design, develop, and maintain scalable ETL/ELT pipelines using Databricks, PySpark, and Delta Lake for large-scale healthcare datasets. Collaborate with data scientists, analysts, and product managers to understand data requirements and deliver clean, reliable data. Ingest, process, and transform healthcare-related data such as claims (837/835), EHR/EMR, provider/member, and clinical datasets. Implement data quality checks, validations, and transformations to ensure high data integrity and compliance with healthcare regulations. Optimize data pipeline performance, reliability, and cost in cloud environments (preferably Azure or AWS). Maintain documentation of data sources, data models, and transformations. Support analytics and reporting teams with curated datasets and data marts. Adhere to HIPAA and organizational standards for handling PHI and sensitive data. Assist in troubleshooting data issues and root cause analysis across systems. Required Qualifications 2–3 years of experience in a data engineering role, preferably in the healthcare or healthtech sector. Hands-on experience with Databricks, Apache Spark (PySpark), and SQL. Familiarity with Delta Lake, data lakes, and modern data architectures. Solid understanding of healthcare data standards: EDI 837/835, CPT, ICD-10, DRG, or HCC. Experience with version control (e.g., Git), CI/CD workflows, and task orchestration tools (e.g., Airflow, Azure Data Factory, dbt). Ability to work with both structured and semi-structured data (JSON, Parquet, Avro, etc.). Strong communication skills and ability to collaborate in cross-functional teams. Education Bachelor’s degree in Business Administration, Healthcare Informatics, Information Systems, or a related field.
Posted 1 week ago
8.0 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, 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. What You’ll Be Doing as A Part of Our Team Identify, analyze, and manage all issues about accounts receivable and member service inquiries. Coordinate, assign, audit, and supervise work with all India BSO teams to ensure productivity standards and goals are consistently met. Review and analyze past-due receivables with BSO global team every week. Monitor cash inflow and identify the roadblock which hindering the cash and highlight the same to the leadership team Active participation in weekly AR calls; denial review call with onshore team Oversee monthly A/R reporting, weekly ATB, 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 AR operations and make suggestions for improvement. Knowledgeable in 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 AR and denial management aspects of revenue cycle management. Preference will be given if have hospital AR experience. 2+ years of management experience leading or supervising billers. Must possess strong working knowledge of CPT, ICD10, Denials, Appeals, & Correspondence 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.
Posted 1 week ago
1.0 years
3 - 3 Lacs
Mohali
On-site
This is a work from office position only. Ideal candidate must have following: Code (CPT and ICD10) all E/M and office procedures. Deep knowledge of auditing concepts and principles. Responsibility of auditing of coding team and maintaining target accuracy %. Adhere to and enforce departmental policies and procedures (coding and compliance). Reviewing office dictation and/or charge ticket (assigned levels by Provider) received from the clinic. Research all coding problems and resolve them with an effective and appropriate solution. Keep up to date on all coding changes by reviewing subscription newsletters (CEUs). Participate in monthly calibration sessions with operations & clients. Providing on the spot feedback. Prepare and review data and QA reporting with key stakeholders. Discuss audit sheets changes on need basis with the operations & clients. Conduct RCA /1 Year analysis on monthly audit data & publish the findings. Conduct monthly quality session for operations teams to share top improvements & preventive actions. Conduct TNA on need basis for junior team members. Facilitate the preparation and processing of daily charge documents. Required Candidate profile: Any life science graduate or postgraduate. B.Sc. Biology preferred. Must have worked on multi specialities including Radiology, ENM, behavioral, nephrology, podiatry, dermatology etc. Must be CPC certified from AAPC or AHIMA, (CPC, COC, CIC, CCS). Experience of medical billing, client management, AR follow up, charge entry, denial management etc. will be added advantage. Should have good knowledge of ICD-9, ICD-10 and/or CPT medical billing codes. Must have medical record auditing experience. Team management experience will be big plus. Proficient in Microsoft 365 office applications like Teams, Outlook, CRM Dynamics, OneDrive etc. Competencies: Excellent verbal and written English business communication skills for interacting with USA based team members/ physicians/vendors/patients. Professional and able to make a great impression on the phone. Required to understand, communicate & work regularly with USA based team. Must have long term association with Chandigarh Tricity area. Must maintain confidentiality of all company, client, employees’ information and not disclose it to any other team member. Ability to work well with others and facilitate teamwork and cooperation. Positive attitude and able to follow directions. Willing to cross train and cross learn other areas of IT, software support. Tact, diplomacy, and the ability to maintain confidentiality of company, client, and patient information. Must have very strong work ethic and excellent attention to detail. Job Types: Full-time, Permanent Pay: ₹25,000.00 - ₹30,000.00 per month Benefits: Food provided Provident Fund Work Location: In person
Posted 1 week ago
3.0 - 4.0 years
0 Lacs
Chennai, Tamil Nadu, India
On-site
Job Family Coding OP (India) Travel Required None Clearance Required None What You Will Do Accurately transforms medical diagnoses and procedures into designated alphanumerical codes in ICD-10-CM , 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. What You Will Need Minimum Qualification Any Life science, Paramedical Graduates and Post Graduates Minimum Experience And Skills Minimum Experience: 3-4 years' experience. AAPC/AHIMA certification 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. What Would Be Nice To Have 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 emergency room coding, exposure to radiology , ancillary worktypes. 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 1 week ago
0 years
1 - 3 Lacs
India
On-site
1. Accurate review and post charges for medical services provided by healthcare providers. 2. Analyze patient encounter documentation such as super bills, operative reports and medical reports to ensure accurate charge capture and appropriate code assignment. 3. Collaborate with coding professionals to verify the accuracy of assigned codes and modifiers, resolving discrepancies or coding related issues before charge posting. 4. Adhere to billing and coding compliance guidelines, including HIPAA regulations, insurance payer guidelines, and government regulation (e.g., Medicare, Medicaid). 5. Maintain high accuracy in charge entry, minimizing errors and discrepancies. 6. Meet or exceed established productivity and timeliness targets for charge posting. 7. Prioritize workload effectively to ensure timely and accurate charge entry. 8. Maintain accurate records and metrics related to charge posting activities. 9. Prepare reports and analysis as needed, highlighting trends, discrepancies, and performance indicators. Skill Set Required: · Prior experience in charge posting or healthcare revenue cycle management. · Good understanding of medical billing, coding and reimbursement processes. · Knowledge of medical terminology, CPT, HCPCS and ICD coding system. · Familiarity with insurance payer guidelines, including Medicare and Medicaid. · Proficient in using healthcare billing systems and electronic medical record (EMR) software. · Strong attention to detail and accuracy. · Excellent analytical and problem solving skills. · Effective communication and interpersonal skills. · Familiarity with HIPAA regulations and compliance requirements. · Candidate with Bachelor’s degree or equivalent is preferred. Job Type: Full-time Pay: ₹15,000.00 - ₹25,000.00 per month Benefits: Food provided Schedule: Day shift Rotational shift US shift Supplemental Pay: Overtime pay Shift allowance Ability to commute/relocate: Saibaba Colony, Coimbatore, Tamil Nadu: Reliably commute or planning to relocate before starting work (Preferred) Education: Bachelor's (Preferred) Shift availability: Night Shift (Preferred) Overnight Shift (Preferred) Work Location: In person
Posted 1 week ago
3.0 years
0 Lacs
Pune, Maharashtra, India
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 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. We are an Equal Opportunity Employer. No job applicant or employee shall receive less favorable treatment or be disadvantaged because of their gender, marital or family status, color, race, ethnic origin, religion, disability or age; nor be subject to less favorable treatment or be disadvantaged on any other basis prohibited by applicable law. For more information, please explore Veradigm.com. What Will Your Job Look Like Responsible to know and facilitate specific accounts and their unique attributes in order to successfully provide customized Our organizations RCS for each account. This is a dual position with its own workload along with oversight to train, audit and monitor the group for accurate procedures and turnaround. Ensure workflow, including collecting payments stays current and on track with regards to insurance carriers, patients, clients and internal interactions. Supports the overall Operations and Client Services by efficiently and effectively providing and reviewing account data needed for the Revenue Cycle process and delivering results. Main Duties Strong customer service skills for client satisfaction, health of client AR and guidance for RCS team members Answers client calls: prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally. Acts as initial point person for team regarding technical work questions/processes/procedures to provide training/guidance. Escalates issues to RCS Management related to clients and staff. Trains individuals on systems and workflow in order to ensure protocols are followed. Reviews and work all unpaid and denied insurance correspondence, both phone appeals and written appeals; confirm all patient demographics and insurance is current and up to date. Runs, reviews and works unpaid patient balance reports for payment by reading current notes and place for past due letters and phone calls. Prepares insurance/patient correspondence for coworkers by reviewing and batching for further attention and review. Prepares and sends uncollected patient payments to collections by writing up forms for the doctors to review. Reviews and works insurance and patient overpayments, prepare refund request and send to doctor's office. Answers phone calls from insurances and patients. Organizes, identifies and improves workflow with team members/Management through daily and weekly productivity reports and reports challenges and concerns and requests need for assistance to RCS Management. Ability to perform the duties of the Payment Entry Specialist, Charge Entry Specialist, AR Specialist and RCM Specialist roles. Keeps manager informed of progress, achievements and issues; assist staff with processes, information and workload. Achieve goals set by management and compliance requirements. Follows, and models adherence to all policies, procedures and processes. Other duties as assigned. Academic Qualifications 3+ years relevant work experience (Preferred) An Ideal Candidate Will Have Compliance Job responsibilities include fostering the Company’s compliance with all applicable laws and regulations, adherence to the Code of Conduct and Compliance Program requirements, policies and procedures. Compliance is everyone’s responsibility. Knowledge, Skills And Abilities Knowledgeable of CPT and ICD coding and medical terminology Extensive knowledge with email, search engines, Internet, ability to effectively use payer websites and Laserfiche; basic competence in use of Microsoft products. Preferred experience with MS Access and PowerPoint, Crystal reports and various billing systems, such as NextGen, Pro, Epic and others Knowledge of CPT, ICD10 and modifiers. Experience in specialties such as Psychiatry, Internal Medicine, Orthopedics, General Surgery Familiar with HMO and IPAs, Medicare Fee for Service Plans and Commercial Payers Strong communication skills Work Arrangements: Work from Pune Office all 5 days. Shift Timing: 7:30 PM IST to 4:30 AM IST (US Shift) 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 1 week ago
1.0 - 6.0 years
4 - 5 Lacs
Pune
Work from Office
Hiring : US HEALTHCARE(AR CALLER- RCM/DENAILS) Location : Pune CTC : Up to 5.5 LPA Shift : US Shift (Night) | 5 Days Working | 2 Days Rotational Off Notice Period: Immediate to 30 Days About the Role We are looking for experienced US HEALTHCARE(AR CALLER- RCM/DENAILS) to join our growing US Healthcare RCM team. Eligibility : Experience: Minimum 1 year in Hiring: US HEALTHCARE(AR CALLER- RCM/DENAILS) Qualification: Any Key Skills: Denial Management & Resolution AR Follow-up / Collections Physician / Provider Billing Prior Authorization HIPAA Compliance How to Apply? Contact: Chanchal- 9251688424
Posted 1 week ago
5.0 years
0 Lacs
Tiruchirappalli, Tamil Nadu, India
On-site
Job Title: Business Analyst – Healthcare Products Experience: 3–5 years Location: Trichy Employment Type: Full-time Job Summary: We are seeking a highly motivated Business Analyst with 3–5 years of experience, preferably in the healthcare products or healthtech domain . The ideal candidate will bridge the gap between business stakeholders and technical teams, focusing on requirements gathering, process improvements, and delivering product features that meet healthcare compliance and user expectations. Key Responsibilities: Work with product managers, stakeholders, and development teams to gather, analyze, and document business requirements related to healthcare products or platforms. Conduct gap analysis, feasibility studies, and workflow mapping for new and existing healthcare solutions. Translate business needs into detailed functional specifications, user stories, and process flows. Support Agile/Scrum teams through backlog grooming, sprint planning, and user acceptance testing (UAT). Collaborate with QA teams to define test cases and ensure delivery aligns with business goals and healthcare regulations. Identify opportunities for process improvements within the healthcare ecosystem. Ensure solutions comply with healthcare standards like HIPAA, HL7, FHIR, etc. (as applicable). Communicate clearly and effectively with stakeholders at all levels. Required Skills & Qualifications: 3–5 years of experience as a Business Analyst, preferably in the healthcare domain (payer, provider, EHR, medical devices, insurance, etc.) . Strong understanding of healthcare workflows , terminology, and regulatory environments. Experience with requirements gathering, BRD/FSD creation , and Agile methodology . Familiarity with FHIR/HL7 , ICD/CPT codes, or healthcare compliance frameworks is a plus. Proficiency in tools like JIRA, Confluence, Visio, MS Excel , etc. Excellent verbal and written communication skills. Bachelor's degree in Business Administration, Health Informatics, Computer Science, or a related field.
Posted 1 week ago
1.0 years
0 Lacs
Hyderabad, Telangana, India
On-site
Job Title: Bench Sales Recruiter Location: onsite (Hyderabad, Andhra Pradesh) Job Description: We are looking for an experienced Bench Sales Recruiter to join our team. The ideal candidate should have a strong understanding of the US staffing market and experience in handling full-cycle recruitment. As a Bench Sales Recruiter, you will be responsible for marketing and placing IT consultants on various client requirements. Key Responsibilities: Market available bench consultants (H1B, OPT, CPT, EAD, GC, USC) for contract positions with vendors and direct clients in the US. Build relationships with Tier 1 vendors and direct clients to place consultants in IT positions. Understand client requirements and match consultant skills with job requirements. Develop and maintain a network of contacts to identify and source qualified consultants. Negotiate contracts, rates, and other terms with vendors, clients, and consultants. Post resumes on job portals such as Dice, Monster, LinkedIn, and other social media platforms. Follow up regularly with clients and consultants for feedback and interviews. Provide prompt and accurate reporting on placement and consultant marketing activities. Qualifications: 1+ years of experience in Bench Sales recruiting in the US IT staffing market. Strong knowledge of US tax terms (W2, 1099, and C2C). Familiarity with visa types and work authorization in the US (H1B, EAD, OPT, CPT, etc.). Excellent communication and negotiation skills. Proven ability to build strong professional relationships with consultants and vendors. Hands-on experience with job portals, social media recruiting, and email marketing tools. Ability to work in a fast-paced environment with minimal supervision. Preferred Skills: Experience in handling multiple consultants and placing them across various technologies such as Java, .NET, AWS, DevOps, etc. Strong understanding of vendor relationships and market strategies. Proficiency in using Applicant Tracking Systems (ATS) and maintaining accurate records. Work Schedule: Ability to work US hours (Night shifts, IST). Compensation: Competitive salary and performance-based incentives.
Posted 1 week ago
1.0 - 6.0 years
5 - 5 Lacs
Pune
Work from Office
Hiring: AR Caller (Denial Management) Location: Pune CTC: Up to 5.5 LPA Shift: US Shift (Night) | 5 Days Working | 2 Days Rotational Off Notice Period: Immediate to 30 Days About the Role We are looking for experienced AR Calling professionals (Provider Side) to join our growing US Healthcare RCM team. Eligibility : Experience: Minimum 1 year in AR Calling (Provider Side) Qualification: Any Key Skills: Revenue Cycle Management (RCM) Denial Management & Resolution AR Follow-up / Collections Physician / Provider Billing Prior Authorization HIPAA Compliance How to Apply? Contact: Sanjana 9251688426
Posted 1 week ago
1.0 - 3.0 years
3 - 6 Lacs
Hyderabad
Work from Office
Training Design and deliver training programs on ICD-10-CM , CPT , and HCPCS coding systems Create instructional materials like handbooks, presentations, and online modules Track performance metrics and maintain detailed training records
Posted 1 week ago
5.0 years
0 Lacs
Hyderabad, Telangana, India
On-site
Job Description: Outpatient Clinical Documentation Improvement (CDI) Specialist: Position Summary: The Outpatient Clinical Documentation Improvement (CDI) Specialist is responsible for ensuring the accuracy, completeness, and compliance of clinical documentation in outpatient medical records. This role collaborates with healthcare providers, coding staff, and compliance teams to improve documentation quality, support accurate coding, and ensure appropriate reimbursement while maintaining regulatory compliance. The CDI Specialist plays a critical role in enhancing patient care quality, data integrity, and revenue cycle efficiency in an outpatient setting. Key Responsibilities: · Documentation Review: Conduct concurrent and retrospective reviews of outpatient medical records to ensure documentation accurately reflects the patient’s clinical condition, treatment, and services provided. · Provider Education: Collaborate with physicians, nurse practitioners, and other healthcare providers to educate them on documentation best practices, including specificity and completeness to support accurate coding and billing. · Query Process: Issue compliant, non-leading queries to providers to clarify ambiguous, incomplete, or conflicting documentation, ensuring alignment with ICD-10-CM, CPT, and Outpatient coding guidelines. · Coding Support: Work closely with coding and billing teams to ensure documentation supports appropriate code assignment, risk adjustment, and reimbursement. · Compliance: Ensure documentation meets regulatory requirements, including CMS, HIPAA, and other federal and state guidelines, to minimize audit risks. · Data Analysis: Monitor and analyze documentation trends to identify opportunities for improvement in clinical documentation processes and provider education. · Quality Improvement: Participate in quality improvement initiatives to enhance patient outcomes, documentation accuracy, and organizational performance metrics. Qualifications: Education: Science Graduate or Postgraduate. Experience: Minimum of 5 years of experience in clinical documentation improvement, medical coding, or outpatient healthcare settings. Strong knowledge of outpatient coding methodologies (ICD-10-CM, CPT, HCPCS) and risk adjustment models. Certifications (one or more preferred): Certified Clinical Documentation Specialist (CCDS) or Certified Documentation Improvement Practitioner (CDIP). Certified Professional Coder (CPC) or Certified Coding Specialist (CCS). Skills: Excellent understanding of clinical terminology, disease processes, and treatment protocols. Strong analytical skills to interpret clinical documentation and identify gaps. Exceptional communication and interpersonal skills to engage with providers and interdisciplinary teams. Proficiency in EHR systems (e.g., Epic, Cerner) and CDI software tools. Detail-oriented with a commitment to accuracy and compliance. Preferred Qualifications Experience in outpatient or ambulatory care settings, such as clinics, physician practices, or urgent care facilities. Knowledge of value-based care models and their impact on documentation and reimbursement. Familiarity with payer-specific documentation requirements (e.g., Medicare Advantage, Medicaid). Requires the ability to work independently and collaboratively in a fast-paced environment. Why Join Us? This role offers a unique opportunity to make a meaningful impact on healthcare quality and reimbursement accuracy. Join a collaborative and supportive team committed to excellence in clinical documentation, compliance, and patient outcomes at Doctus. Take the Next Step in Your CDI Career: Apply now and play a key role in shaping the future of clinical documentation integrity! How to Apply Please submit a resume and cover letter to recruiter@doctususa.com . Please include “ Outpatient CDI Specialist Application ” in the subject line.
Posted 1 week ago
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