Department: Medical Coding

Designation: Medical Coder

Experience Required: 1 – 5 Years

Job Role

• Performing medical coding and reviewing medical codes for adherence to risk adjustment models
• Maintain standard industry productivity rates for risk adjustment coding
• Demonstrated ability to maintain high quality standards of 95% or greater
• Adherence to ISO procedures and compliances
• Mandatory to have a Certified Risk Adjustment Coder (CRC) Certification

Job Requirements

• • Bachelor’s Degree or equivalent required
  • Minimum one (1) year experience with CMS HCC (Hierarchical Condition Category) risk adjustment coding preferred
  • Successful completion of coding certification program (CCS, CPC, CRC, or RHIT through AHIMA/AAPC)
  • Extensive knowledge of Medicare regulations and policies pertaining to documentation, coding, and billing.
  • Excellent growth opportunities
  • Thorough understanding of ICD-10-CM coding guidelines
  • Excellent written and verbal communication skills to effectively communicate coding and documentation findings both internally and externally
  • Experience with computer applications, including MS Office (Excel, Word, PowerPoint) required.
  • Comfortable working in a department with set productivity and coding accuracy standards
  • Experience with NCQA HEDIS programs and data collection preferred
  • Ability to self-motivate and work independently with minimal supervision

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Department: Revenue Cycle

Designation: Manager – Revenue Cycle

Experience: 10+ years

Shifts: India Night Shift / US Shift

Job Role

• Providing leadership and focus to the operations team
• Delivering production and quality as per SLA for all the teams
• Handling day-to-day operations and managing resources through all shifts
• Capacity management. Staffing on day-to-day basis.
• Attrition and shrinkage control
• Transition and ramp-up assistance
• Single point of contact for clients, implementation, and senior management team and to give a strategic view of the transition
• Able to design transition roadmap for all new clients and present solutions
• internally/externally depending upon the nature of the client’s business.
• Able to perform due diligence during transition period according to client’s SLA and set
• expectations for internal operations team and client.
• To ensure all possible risks that can impact project timelines and mitigation/CAPA/back-up plan is in place. Brainstorming with team for possible risk and providing solutions
• Coordinating with all cross functional team for transition (HR, IT, Recruitment, Admin, Sales)
• Develop an over-all transition plan and knowledge transfer to all HOD
• Develop good relationships with clients, support departments and operations team
• Strong analytical, problem solving abilities & complexity management Grievance handling
• Identifying training needs and coordinating with training department
• Change Management
• Involved in the interview process as and when needed

Job Requirements

• • Six-Sigma/MBA will be an added advantage
  • Having end-to-end knowledge of healthcare revenue cycle management as well as coding on provider side
  • Coding certification required
  • Minimum 6-8 years of experience in transition and 3-5 years in US healthcare
  • Excellent knowledge of MS office

• Apply Now

Department: Revenue Cycle

Designation: Claims Executive / Senior Claims Executive

Experience Required: 1 to 5 years

Shifts: India Night Shift / US Shift

Job Role

• Responsible for charge posting, payment posting, denial management, claims rejections, eligibility verification for members
• Ensure quality and production meet industry standards
• Constantly keeps track of both electronic and paper claims
• Review provider claims that have not been paid by insurance companies
• Watchful for any major rejections or denials from clearing houses/carriers indicating a systemic issue
• Track payments and EOBs from major Carriers, pay-to-address, provider numbers, etc.

Job Requirements

• Undergraduate / Graduate
• Should have basic knowledge of revenue cycle management
• Sound knowledge of U.S. healthcare domain (provider side)
• Basic knowledge of computers
• Willing to work as per US calendar and US shifts
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Department: Revenue Cycle

Designation: AR Caller / Senior AR Caller

Experience Required: 1 to 5 years

Job Role

• Ensure that the quality and production are met as per expectations
• Responsible for calling insurance companies in the US and following-up on outstanding accounts receivable
• Knowledge of HIPAA, Insurances and their Plans, Worker’s Comp, No-Fault
• Understanding of denials and denial reasons and obtain resolution from carriers
• Claim submission – Electronic, Paper or Direct Data Entry (DDE)

Job Requirements

• Undergraduate / Graduate
• Minimum typing speed of 25wpm
• Basic knowledge of computers
• Willing to work as per US calendar and US shifts
• Prior experience in accounts receivable would be an advantage
• Good oral and written communication skills (English)

• Apply Now

Department: Revenue Cycle

Designation: AR Caller / Senior AR Caller

Experience Required: 1 to 5 years

Job Role

• Review chart document to ensure patient meets medical policy guidelines.
• Prioritize incoming authorization requests according to urgency.
• Obtain authorization via payer website or by phone and follow-up regularly on pending cases.
• Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations.
• Initiate appeals for denied authorizations.
• Respond to clinic questions regarding payer medical policy guidelines.
• Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
• Contact patients to discuss authorization status (if required)

Job Requirements

• UG, Graduate or Postgraduate Degree
• Knowledge of US healthcare domain
• Knowledge of Pre-Auth/Referral
• Proficient use of CPT and ICD-10 codes
• Calling etiquettes
• Ability to multitask and remain focused while managing a high-volume, time-sensitive workload

• Apply Now

Department: Marketing & Sales

Designation: BD Executive

Experience Required: Minimum 2 years

Job Role

• Responsible for selling revenue cycle services to healthcare providers in the US
• Fix appointments for our sales directors
• Cold calling, prospect building, lead generation and client servicing

Job Requirements

• Minimum two (2) years of RCM sales experience in the US healthcare provider market
• Ability to research and build own database
• Strong networking skills
• Excellent written, verbal and presentation skills
• Ability to build a strong prospect list

• Apply Now