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Senior Executive at EXL Talent Acquisition Team

Noida, Uttar Pradesh, India -

Full Time

Start Date

Immediate

Expiry Date

07 Jun, 26

Salary

0.0

Posted On

09 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clinical Decision Making, Clinical Reviews, Medicare Compliance, Ticket Management, Service Requests, Device Requests, Break Fix, Request Validation, Approvals Confirmation, Turnaround Time Adherence, Knowledge Transfer, Process Improvement

Industry

Business Consulting and Services

Description

Works with Regional Medical Directors to make sound, evidence based clinical decisions regarding the requested cases (treatments and procedures) for IP/OP and performs retrospective clinical reviews utilizing criteria set forth by the client and Medicare (CMS-Centers for Medicare and Medicaid Services) and perform outbound calls to providers.

Responsibilities

The role involves collaborating with Regional Medical Directors to make evidence-based clinical decisions for requested treatments and performing retrospective clinical reviews against client and CMS criteria. Additionally, the incumbent will handle IT service requests, including device provisioning and break/fix issues, by monitoring ticket queues and executing required actions.