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Hiring For Manager & Sr. Manager- Medical Audit

Hiring For Manager & Sr. Manager- Medical Audit

Virtuoso Staffing Solutions

6 - 11 years

|

10 - 12 Lacs

New Delhi Gurugram Delhi / NCR

Posted:4 days ago| Platform:

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Skills Required

Claims Audit Claims Auditing Medical Audit High value claims Claims Abjudication inpatient CPT US Healthcare Medical Auditor outpatient Claims processing Dollar value claims NCCI

Work Mode

Work from Office

Job Type

Full Time

Job Description

Roles and Responsibilities

Conduct medical audits for high-value claims, including inpatient and outpatient services.
Review NCCI guidelines to ensure accurate coding and compliance with US healthcare regulations.
Analyze CPT codes to identify discrepancies and optimize claim processing.
Collaborate with internal stakeholders to resolve issues related to claims adjudication.
Develop expertise in dollar value claims handling, focusing on accuracy and efficiency.

Desired Candidate Profile

6-11 years of experience in Medical Audit or Claims Auditing/Audition role.
Strong understanding of CPT, ICD-10-CM/PCS, HCPCS Level II codes; knowledge of anesthesia codes (G0152) preferred.
Experience working with High Value Claims (HVC) is essential; familiarity with NCCI guidelines a plus.

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