Current Opening

CPC Coders

Department: Medical Coding

Designation: Medical Coder

Experience Required: 1 – 5 Years

Job Location: Pune/Mumbai

Shifts: General or India Night Shift

Job Role

  • Complying with medical coding guidelines and policies
  • Reviewing & analysing patients’ charts and documents for verification and accuracy
  • Account for coding and abstracting of patient encounters
  • Research and analyse data needs for reimbursement
  • Make sure that codes are sequenced according to government and insurance regulations
  • Ensure all medical records are filed and processed correctly
  • Analyse medical records and identify documentation deficiencies
  • Serve as resource and subject matter expert to other coding staff
  • Review and verify documentation for diagnoses, procedures and treatment results
  • Identify diagnostic and procedural information

Job Requirement

  • CPC Certified
  • Proven work experience as a Medical Coder or similar role
  • Experience across specialties
  • Proficient computer skills
  • Experience on different coding softwares & tools.
  • Excellent communication skills, both verbal and written
  • Outstanding organizational skills
  • Ability to maintain the confidentiality of information
  • Graduation required
Apply Now

Risk Adjustment Coder

Department: Medical Coding

Designation: Medical Coder

Experience Required: 1 – 5 years

Job Location: Pune/Mumbai

Shifts: General/US Shifts

Job Role

  • Performing medical coding and reviewing medical codes for adherence to risk adjustment models
  • Maintain standard industry productivity rates for risk adjustment coding
  • Demonstrated ability to maintain high quality standards of 95% or greater
  • Adherence to ISO procedures and compliances
  • Mandatory to have a Certified Risk Adjustment Coder (CRC) Certification

Job Requirements

  • Bachelor’s Degree or equivalent required
  • Minimum one (1) year experience with CMS HCC (Hierarchical Condition Category) risk adjustment coding preferred
  • Successful completion of coding certification program (CCS, CPC, CRC, or RHIT through AHIMA/AAPC)
  • Extensive knowledge of Medicare regulations and policies pertaining to documentation, coding, and billing.
  • Excellent growth opportunities
  • Thorough understanding of ICD-10-CM coding guidelines
  • Excellent written and verbal communication skills to effectively communicate coding and documentation findings both internally and externally
  • Experience with computer applications, including MS Office (Excel, Word, PowerPoint) required.
  • Comfortable working in a department with set productivity and coding accuracy standards
  • Experience with NCQA HEDIS programs and data collection preferred
  • Ability to self-motivate and work independently with minimal supervision
Apply Now

Home Health Coder

Department: Medical Coding

Designation: Medical Coder / Sr. Medical Coder

Experience Required: 1 to 2 years

Job Location: Pune/Mumbai

Job Role

  • The home health coder is responsible for assigning diagnostic codes to patient charts using ICD-10-CM in accordance with coding rules and regulations
  • The coder will abstract required clinical information. This position requires in-depth knowledge of medical terminology, disease processes, pharmacology, Patient-Driven Grouping Model (PDGM), official coding guidelines (ICD-10-CM & OASIS-D1) and documentation requirements for correct and accurate coding.
  • Maintain standard industry productivity rates for home health coding
  • Demonstrated ability to maintain high quality standards of 95% or greater

Job Requirement

  • Minimum 1 year of experience in home health coding
  • Must have ICD-10 coding experience
  • Must have completed an ICD-10 course
  • Knowledge of OASIS D-1 is required
  • Advanced computer skills with experience with one or more electronic medical record software
  • Excellent written and verbal skills, interpersonal skills and aggressive approach to excellence
  • Ability to work under pressure and take on multiple tasks
  • Strong quantitative and analytical skills
  • Must have own PC with Windows 10 Pro and reliable high-speed Internet service
  • Must pass candidate assessment test with a minimum score of 85%
Apply Now

Revenue Cycle Manager

Department: Revenue Cycle

Designation: Manager – Revenue Cycle

Experience: 10+ years

Job Location: Pune

Shifts: India Night Shift / US Shift

Job Role

  • Providing leadership and focus to the operations team
  • Delivering production and quality as per SLA for all the teams
  • Handling day-to-day operations and managing resources through all shifts
  • Capacity management. Staffing on day-to-day basis.
  • Attrition and shrinkage control
  • Transition and ramp-up assistance
  • Single point of contact for clients, implementation, and senior management team and to give a strategic view of the transition
  • Able to design transition roadmap for all new clients and present solutions
  • internally/externally depending upon the nature of the client’s business.
  • Able to perform due diligence during transition period according to client’s SLA and set
  • expectations for internal operations team and client.
  • To ensure all possible risks that can impact project timelines and mitigation/CAPA/back-up plan is in place. Brainstorming with team for possible risk and providing solutions
  • Coordinating with all cross functional team for transition (HR, IT, Recruitment, Admin, Sales)
  • Develop an over-all transition plan and knowledge transfer to all HOD
  • Develop good relationships with clients, support departments and operations team
  • Strong analytical, problem solving abilities & complexity management Grievance handling
  • Identifying training needs and coordinating with training department
  • Change Management
  • Involved in the interview process as and when needed

Job Requirement

  • Six-Sigma/MBA will be an added advantage
  • Having end-to-end knowledge of healthcare revenue cycle management as well as coding on provider side
  • Coding certification required
  • Minimum 6-8 years of experience in transition and 3-5 years in US healthcare
  • Excellent knowledge of MS office
Apply Now

Medical Biller & Payment Poster

Department: Revenue Cycle

Designation: Claims Executive / Senior Claims Executive

Experience Required: 1 to 5 years

Job Location: Pune

Shifts: India Night Shift / US Shift

Job Role

  • Responsible for charge posting, payment posting, denial management, claims rejections, eligibility verification for members
  • Ensure quality and production meet industry standards
  • Constantly keeps track of both electronic and paper claims
  • Review provider claims that have not been paid by insurance companies
  • Watchful for any major rejections or denials from clearing houses/carriers indicating a systemic issue
  • Track payments and EOBs from major Carriers, pay-to-address, provider numbers, etc.

Job Requirements

  • Undergraduate / Graduate
  • Should have basic knowledge of revenue cycle management
  • Sound knowledge of U.S. healthcare domain (provider side)
  • Basic knowledge of computers
  • Willing to work as per US calendar and US shifts
Apply Now

Accounts Receivable Executive

Department: Revenue Cycle

Designation: AR Caller / Senior AR Caller

Experience Required: 1 to 5 years

Job Location: Pune

Job Role

  • Ensure that the quality and production are met as per expectations
  • Responsible for calling insurance companies in the US and following-up on outstanding accounts receivable
  • Knowledge of HIPAA, Insurances and their Plans, Worker’s Comp, No-Fault
  • Understanding of denials and denial reasons and obtain resolution from carriers
  • Claim submission – Electronic, Paper or Direct Data Entry (DDE)

Job Requirements

  • Undergraduate / Graduate
  • Minimum typing speed of 25wpm
  • Basic knowledge of computers
  • Willing to work as per US calendar and US shifts
  • Prior experience in accounts receivable would be an advantage
  • Good oral and written communication skills (English)
Apply Now

Prior Authorization Executive

Department: Revenue Cycle

Designation: Medical Benefits & Authorization Executive

Experience Required: 2-4 years

Job Location: Pune

Shift: India Night Shift / US Shift

Job Role

  • Review chart document to ensure patient meets medical policy guidelines.
  • Prioritize incoming authorization requests according to urgency.
  • Obtain authorization via payer website or by phone and follow-up regularly on pending cases.
  • Maintain individual payer files to include up to date requirements needed to successfully obtain authorizations.
  • Initiate appeals for denied authorizations.
  • Respond to clinic questions regarding payer medical policy guidelines.
  • Confirm accuracy of CPT and ICD-10 diagnoses in the procedure order
  • Contact patients to discuss authorization status (if required)

Job Requirements

  • UG, Graduate or Postgraduate Degree
  • Knowledge of US healthcare domain
  • Knowledge of Pre-Auth/Referral
  • Proficient use of CPT and ICD-10 codes
  • Calling etiquettes
  • Ability to multitask and remain focused while managing a high-volume, time-sensitive workload
Apply Now

Business Development Executive

Department: Marketing & Sales

Designation: BD Executive

Experience Required: Minimum 2 years

Job Location: Pune/Mumbai

Job Role

  • Responsible for selling revenue cycle services to healthcare providers in the US
  • Fix appointments for our sales directors
  • Cold calling, prospect building, lead generation and client servicing

Job Requirements

  • Minimum two (2) years of RCM sales experience in the US healthcare provider market
  • Ability to research and build own database
  • Strong networking skills
  • Excellent written, verbal and presentation skills
  • Ability to build a strong prospect list
Apply Now
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