- Job Description: Responsible for managing Nurse auditors and other contract auditors to ensure smooth operations of daily activities and ensuring that audit productivity and quality standards are met.
- Perform best practice reviews and identify areas for improvement. Performs beyond one role among Clinical auditor, QC and dispute. Training and guiding reviewers for enhancement
- Verifying the patient information, other insurance information, Validating the paid information and contract to identify the overpayments.

Responsibilities: Qualifications:
- Bachelor’s degree in nursing
- Active State Nursing certification is Mandatory
- Minimum 4 years of clinical/hospital experience is mandatory

Communication:
- Robust written (documentation) and oral communication skills

Experience:
- Minimum 4 years of clinical experience.
- Auditing experience (Optional)

Working Hours:
- 40 hours per week as Full-time employee
- Shift time: 08:00 AM TO 05:00 PM IST (It might be changed based on project requirements)
- Weekends: Off

Telecommuter/Internet requirements, if applicable:




- High Speed internet connection at home, must be broadband
- Must understand and adhere with telecommuter policy

Qualifications: Computer Literacy

Microsoft Office

Quality Auditing experiencce

Familiarity with basic medical terminology and concepts used in care management.
- Ability to effectively participate in a multi-disciplinary team including internal and external participants.
- Should have a good understanding of US healthcare system and management.
- Perform audit based on clinical knowledge while reviewing the medical record
- Demonstrate learning skills during process training and in advancing career
- Perform quality assurance reviews to assess comprehension of training efforts.
- Ensure to process the audit with accountability
- Ensure to view all documented system information as well as any additional records/data presented to support a determination or recommendation.
- Condenses a

📌 Senior Executive (Chennai)
🏢 EXL Service
📍 Chennai