Executive at EXL Talent Acquisition Team

Noida, Uttar Pradesh, India -

Full Time

Start Date

Immediate

Expiry Date

23 Aug, 26

Salary

0.0

Posted On

25 May, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Coding, Medical Billing, HIPAA Compliance, Medical Terminology, Analytical Skills, Critical Thinking, Healthcare Information Systems, Microsoft Excel, English Communication, Data Analysis, Claims Administration, Problem Solving

Industry

Business Consulting and Services

Description

Basic Function This position is responsible for reviewing, analyzing and interpreting medical Information to assess and determine appropriate next action steps which may lead to denial or payment of claims. Work is performed under general supervision according to established guidelines. This individual promotes capabilities from a customer perspective, aligning needs with the target offering by creating a customer self-service enabled platform for core customers. Essential Functions * Responsible for reviewing and analyzing discrepancies by cross-verifying from different data sources * Familiar with US Healthcare domain knowledge and understanding of healthcare regulations (HIPAA) * Deep understanding of medical coding, billing, and medical terminologies * Attention for detail, and Strong analytical skills for processing medical documentation * Critical thinking and high independent decision making capability * Proficiency in healthcare information systems * Ability to navigate through multiple applications * Operates with urgency in a real time service environment * Meets individual goals while assisting team to meet team goals * Defines, communicates and manages workflow and data coordination to support various implementation related reports (i.e., reporting, inventory, capacity reporting, and ad-hoc reports as needed by management) * May perform other duties as assigned * Making outbound calls to agent, hospitals, pharmacy and doctors office to capture missing or required information Performance parameters * Productivity * Quality * Turn Around Time of work assigned * Attendance & Schedule Adherence Primary Internal Interactions: * SME/AM/LAM/Manager for the purpose of reporting performance, escalation handling, clarifying concerns, and seeking support * AM/LAM for the purpose of settling issues left unresolved by the SME and monthly evaluation of performance * SME for the purpose of handling process related issues; queries and escalated transactions * QCA for the purpose of associate performance feedback and audit in order to update the training curriculum * Mentors for the purpose of seeking clarifications and answering queries real time

Responsibilities

Responsible for reviewing and analyzing medical information to determine the payment or denial of healthcare claims. This role involves cross-verifying data sources and coordinating workflows to support implementation reports.