ESSENTIAL JOB RESPONSIBILITIES:
Accurately responding to research related queries and proposing suggestions for rule changes if applicable.
Develop potential rules that can be applied for iHT clients to adjudicate claims accurately relative to medical policy. Review State Medicaid guidelines to identify possibility of inappropriate edits for Medicaid claims.
RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS
- Medical degree (MBBS or MD) / Certified medical coder / BHMS / BAMS
- Clinical experience is a must
- Clearance of all major exams (SSC, HSC, qualifying degree) in first attempt
- Clearance of cognitive aptitude test analytical, quantitative, and logical reasoning skills
- Experience in private sector/ Health plan operations with focus on reimbursement and/or claims processing and/or medical coding preferred
- Knowledge of ICD-10 coding preferred
Contact Person: Mohsin
Accurately responding to research related queries and proposing suggestions for rule changes if applicable.
Develop potential rules that can be applied for iHT clients to adjudicate claims accurately relative to medical policy. Review State Medicaid guidelines to identify possibility of inappropriate edits for Medicaid claims.
RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS
- Medical degree (MBBS or MD) / Certified medical coder / BHMS / BAMS
- Clinical experience is a must
- Clearance of all major exams (SSC, HSC, qualifying degree) in first attempt
- Clearance of cognitive aptitude test analytical, quantitative, and logical reasoning skills
- Experience in private sector/ Health plan operations with focus on reimbursement and/or claims processing and/or medical coding preferred
- Knowledge of ICD-10 coding preferred
Contact Person: Mohsin
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