Designation: Associate Consultant
Job Level: JL 4B
Work location: Mangalore (Work from Office)
Exp: 5-8 years
Notice Period: Immediate to 15 Days
Shift Timings: Night Shift(US Shift)
Qualification: BSc/MSc nursing with NCLEX certification and active US RN license (Desk side experience)
:
1. Senior SME Skillset: Training, Data Management and reporting, Quality Tools, Descriptive Analysis, New project Implementation.
2. Perform medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and Standard Operating procedures.
3. Clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred.
4. Positive understanding of US healthcare business
5. Knowledge of utilization management processes (preferred)
6.
Ability to understand Milliman guidelines (preferred)
7. Knowledge of managed care, acute care, emergency room, cardiology, radiology, etc.
8. Understanding of ICD and CPT codes.
Technical Skill Set: Microsoft Word, Excel, Computer navigation, typing skills, effective communication skills, both verbal and written
Interested candidates please share your updated resume and below details to
[email protected]
Details
Name
Contact Number
Email I'd
DOB
Total Years of Exp
Relevant Years of Exp
Current/ Previous Company Name
Notice Period
Current Location
Preferred Location
Current CTC
Expected CTC
Flexible for Night Shifts
Graduation
Post-Graduation (If applicable):
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