Clinical Reviewers, Medical Coders, Operations, Bangalore

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Clinical Reviewers  Review medical records and follow stringent protocols to determine whether patients meet the standards for insurance reimbursement. Clinical review for medical necessity of identified claims. Documentation of clinical rationale supporting findings of the review. Apply clinical judgment, honed over years in acute care settings, to make responsible decisions that promote appropriate records review and applications usage while keeping resources available to those most in need. Have understanding of ICD-9, CPT and HCPCS codes and their application in the US Health insurance domain. Review and validate all information pertaining to the claim.  Comply with procedures, regulations, and rules in maintaining medical records. Interacts on a continuous basis with other departments by directing activities towards positive outcomes.  Registered Nurse– Hiring Profile Desirable skillsets •    NCLEX certification (Mandatory) •    Nursing Graduate (Bachelors or Masters in Nursing) from registered nursing college in India •    Clinical experience of minimum 2 years for working in a hospital •    Proficiency in English grammar & good writing skills Preferable Skillsets •    Minimum experience of 1 year working in US Healthcare organization •    Proficiency in MS Office tools •    Good verbal and written communication skills Maximum Salary – 5 LPA Medical Coders Process 1: Multi Speciality Coding – Denial Management Payer side. CPC certification must Exp: 0 to 18 months CTC: 2.5 to 3.5 LPA Process2: E/M Coding or Auditing CPC Certification must Exp: 0 – 3 years CTC: 2.5 to 3.75 LPA 5 days’ work 2 days off. Attractive OT and Holiday pay. Note- all are US process and will be working in US shift i.e. 4.30 PM or 5.30 PM log in and two way transportation will be provided free of cost. Salary: 3.50 LPA Interested candidates, please share your profiles to Don't forget to mention Indian Clinical Reviewers or Medical Coders, Bangalore in subject line