mdi-networx specializes in developing integrated network solutions for various sectors including education, healthcare, and corporate environments. Their services encompass network design, implementation, and management.
Pune
INR 1.0 - 3.25 Lacs P.A.
Work from Office
Full Time
Job description We are looking for candidates with 0 to 6 month of experience in voice-based customer service or call center roles, especially with exposure to US clients. If you have excellent verbal and written communication skills in English, strong problem-solving abilities, and a customer-centric approach, we want to hear from you! Requirements: - 0 to 6 month years of experience in voice-based customer service or call center roles. - Excellent verbal and written communication skills in English. - Strong problem-solving abilities and a customer-centric approach. - Ability to handle customer queries with professionalism and patience. - Willingness to learn and adapt in a dynamic work environment. Apply Now! Send your CV to swastikam@mdinetworx.com
Pune
INR 9.0 - 15.0 Lacs P.A.
Work from Office
Full Time
Position Overview: MDI NetworX is seeking a Deputy Manager / Manager Payer Operations to oversee end-to-end healthcare payer processes, drive operational excellence, and ensure compliance with US healthcare standards. This leadership role requires expertise in process optimization, stakeholder management, and team development Key Responsibilities: Lead and manage payer operations, ensuring efficiency and quality in service delivery. Develop and implement strategies to optimize claims processing, enrollment, and provider data management. Drive team performance, coaching, and professional development initiatives. Conduct salary negotiations and oversee talent acquisition for the department. Ensure compliance with HIPAA, ACA, and other payer regulations. Manage escalations, resolve critical process issues, and implement continuous improvement initiatives. Collaborate with senior leadership, clients, and cross-functional teams to enhance operational effectiveness. Monitor key performance indicators (KPIs) and generate actionable reports. Required Skills & Qualifications: Bachelors degree or equivalent experience. 8-12 years of experience in US healthcare payer operations. Strong expertise in claims adjudication, enrollment, and provider data management. Proven experience in leadership, stakeholder management, and process optimization. Proficiency in MS Office, healthcare payer systems, and data analytics. Excellent strategic thinking, communication, and problem-solving skills. Preferred Qualifications: Experience with Medicare, Medicaid, and commercial payer processes. Knowledge of EDI transactions (837, 835, 834). Prior experience in a BPO or shared services environment
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