Clinical Investigator

Orcapod Services
  • Delhi
  • 1-6 lakh
  • 0-5 years
  • Views
  • 13 Jun 2018

  • Sales & Marketing

  • Hospitals/ Health Care
Job Description

Purpose of Job This process works on identifying discrepancies between medical records and billed services for complex and high value claims by identifying Up-coding, Unbundling, Duplication, and Misrepresentation of services. They approve/deny claims & Identify provider aberrant behavior patterns. The associates prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT/ diagnosis codes, CMC guideline along with referring to client specific guidelines and member policies Job Responsibilities -Prevent the payment of potentially fraudulent and/or abusive claims utilizing medical expertise, knowledge of CPT/diagnosis codes , CMC guideline along with referring to client specific guidelines and member policies -Adherence to state and federal compliance policies and contract compliance -Assist the prospective team with special projects and reporting Required Qualifications: Medical degree - BHMS/BAMS/BUMS/BPT/MPT 0 to 3 years of overall experience (Freshers can apply) BDS experienced (2 Years Corporate experience )


Competencies/Skill sets for this job

Medical Records Bhms Bams Clinical Investigator Medical Investigator

Job Posted By

Tarunesh
Managing Principal

About Organisation

Orcapod Services