Other Healthcare Data Processing Functionss in All Locations - 8 job opening/s found

  • Nov 16, 2020
  • Picadilly Star, Bonifacio Global City
The Operations Support Manager will be responsible for managing teams of Operations/Coding support as well as Clinical RN/Audit support. This position will serve as a Manager for Payment Accuracy teams and will direct and support the day to day activities of assigned staff, provide accurate and timely resolution for lines of business and work closely with US Payment Accuracy Solution teams. The manager will act with expertise using clear and effective verbal and written communication skills, ... Read more
  • Nov 16, 2020
  • Picadilly Star, Bonifacio Global City
The Claim Review Operations Manager will be responsible for managing teams of Operations/Coding support as well as Clinical RN/Audit support. This position will serve as a Manager for Payment Accuracy teams and will direct and support the day to day activities of assigned staff, provide accurate and timely resolution for lines of business and work closely with US Payment Accuracy Solution teams. The manager will act with expertise using clear and effective verbal and written communication ... Read more
  • Nov 16, 2020
  • Picadilly Star, Bonifacio Global City
The Claim Review Operations Manager (DRG Validation) will be responsible for managing teams of Operations/Coding support as well as Clinical RN/Audit support. This position will serve as a Manager for Payment Accuracy teams and will direct and support the day to day activities of assigned staff, provide accurate and timely resolution for lines of business and work closely with US Payment Accuracy Solution teams. The manager will act with expertise using clear and effective verbal and written ... Read more
  • Nov 9, 2020
  • Picadilly Star, Bonifacio Global City
The Coding Analyst possesses a solid understanding of CPT Coding and CMS rules and regulations along with excellent writing and computer skills. This position frequently researches and interprets healthcare correct coding using regulatory requirements and guidance related to CMS, CPT/AMA and other major payer policies. They also use internal business rules to prepare written documentation of findings through medical record review. The Coding Analyst possesses an overall understanding of all ... Read more
  • Nov 9, 2020
  • Picadilly Star, Bonifacio Global City
The Clinical Content Analyst/Developer researches, analyzes and creates clinical content for the business rules for Change Healthcare’s Clinical Claims Management (CCM). The CCM Product Line is a fast-paced environment with contractually driven quarterly deliverables. The CCM products are utilized by payer organizations to augment claims management systems, by electronically auditing medical claims, for accurate processing of both professional and facility claims.The role of the ... Read more
  • Oct 28, 2020
  • Picadilly Star, Bonifacio Global City
The Insight Analyst Assistant is responsible for providing support to the Insight Record Review, Clinical, and Coding Operations teams in order to facilitate the administrative components of case analysis for various record review services. Acts as a liaison between external parties such as hospitals, physicians, health plans, vendors, patients, and referral sources and Insight Record Review Team. Interacts with other internal clients such as client services, account managers, data analysts ... Read more
  • Oct 7, 2020
  • Picadilly Star, Bonifacio Global City
The Clinical Review Nurse is responsible for reviewing post service claims to identify aberrant coding and billing patterns through review of related medical records.Responsibilities: Includes, but not limited to:Conducts clinical review of medical records and supporting documentation against submitted claims for; professional and facility claims to validate coding and billing accuracy, including complex and forensic reviews as needed.Independently manage workload that meets or exceeds ... Read more
  • Oct 7, 2020
  • Picadilly Star, Bonifacio Global City
The Insight Analyst will be responsible for reviewing healthcare claims for possible fraud, waste and abuse. Actively work to identify and prevent payment of inappropriate or erroneous charges submitted by healthcare providers. Required to manage workload to ensure that cases are handled appropriately and resolved in a timely manner.Responsibilities:Triage assigned client claims and make determinations on opening cases for medical record reviewProperly manage daily workload to ensure that ... Read more