• The candidate will be responsible for conducting audits on healthcare claims to identify any billing aberrancy basis the clinical recommendations/judgment and review of the invoice, medical documents (if any), and payer-specific policies and guidelines
• Identify any specific billing patterns or trends from different providers monthly
• Communicate and coordinate with the clinical coordinator from client-side
• Demonstrate ability to consistently meet or exceed targets and benchmarks
• Maintain audit log and prepare and share MI from the audit log
• Handle Customer Queries from providers or members via emails. Qualifications we seek in you!
• Graduate (Preferably BHMS/BUMS)
• Good knowledge of healthcare & medical terminologies Preferred qualifications
• Eye for detail & investigative skills
• Good interpretation & comprehension skills
• Excellent medical/clinical Knowledge across specialties, such as internal medicine, surgery, orthopedics, neurology, etc.
• Excellent communication skills (written & verbal) • Demonstrable analytical skills specific to clinical audit in practice
• Customer Orientation and Solution-oriented
• Ability to ask the right queries
• Ability to prioritize and organize own workload
ICT Academy is an initiative of the Government of India in collaboration with the state Governments and Industries. ICT Academy is a not-for-profit society, the first of its kind pioneer venture under the Public-Private-Partnership (PPP) model that endeavors to train the higher education teachers and students thereby exercises on developing the next generation teachers and industry ready students.
ICT Academy was started to meet the skill requirements of the industry and generate more employment especially in tier 2 and 3 towns, the rural parts of the country. The organization was formed with representations from the State Government of Tamil Nadu, leading companies in the ICT industry and National Association of Software Services Companies (NASSCOM) in India.