Job Description

Identify cases eligible for medical reviews and assign these to appropriate reviewers.

Reach out to the client for any problems identified in the cases for review.

Adhere to Utilization Review Accreditation Commission (URAC), jurisdictional, and/or established MediCall best practice UM time frames, as appropriate.

Adhere to federal, state, URAC, client, and established MediCall best practice WCUM time frames, as appropriate.

Develop a complete understanding of the Medical management Procedures.

Perform medical review assessment (MRA) on utilization of health services (eg healthcare plans, workers compensation products etc) in an accurate, efficient and timely manner while ensuring compliance with utilization management regulations and adherence to state and federal mandates.

Provide succinct negotiable points based on the submitted medical records that identify necessary medical treatment, casually related care, response or lack of response to treatment, etc.

Identify missing records and information that are necessary in the completion of the medical review assessment.

Adhere to Department of Labor, state and company timeframe requirements.

Coordinates physician reviewer referral as needed and follows up timely to obtain and deliver those results.

Track status of all utilization management reviews in progress and follow up on all pending cases.

Work closely with management team in the ongoing development and implementation of utilization management programs.

Respond to inbound telephone calls pertaining to medical reviews in a timely manner, following client a established protocols.

Process customer calls consistent with program specified strategies and customer satisfaction measurements to include but not limited to proper answering procedure, eg opening and closing remarks.

Learn new methods and services as the job requires.

Ct:

HR Lavanya

  • Experience

    0 - 1 Years

  • No. of Openings

    50

  • Education

    BDS, BAMS, B.Pharma, B.Sc, B.E, BVSC, M.Pharma, M.Sc, M.Tech, MVSC

  • Role

    Bhms Doctor

  • Industry Type

    Hospitals / Medical / Healthcare Equipments

  • Gender

    [ Male / Female ]

  • Job Country

    India

  • Type of Job

    Full Time

  • Work Location Type

    Work from Office

About Achievers Spot

Achievers Spot is a leader in providing Medical Coding training and placement services in Chennai. We are counted as building a platform where people can come and explore exciting and lucrative careers. We have team of dedicated Trainers and consultants with hands-on experience in healthcare field.
Read More...
Similar Jobs
Apply Now

Register to Get Relevant Jobs

Get Noticed By Top Recruiters

Become a Premium Job Seeker

  • Higher Boosting
  • Resume Highlighter
  • Verified Stamp
  • Resume Exposure

499/- for 3 months

Pay Now

Similar Jobs

BHMS Fresher Jobs

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NursingWalk inPharmacistPhysiotherapistBiotechnologyBiomedical EngineeringBioinformaticsBiochemistryMicroMicrobiologyBDSBHMBhmsBams Doctor

Physiotherapist Jobs Freshers in Chennai

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Wanted Paramedical Graduates in Tirupati/ Hyderabad

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Jobs For 15-24 Passout Pharma/m/m,Pharm/m/pharmacist Grad

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Immediate Recruitment For GNM,(UG/PG) Nursing Freshers- Medical Coding

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Medical Coder -Jobs For Biotech,Biotechnology Engineers,Biomedical Engineer

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Job For 15-24 Passout Nanotech,Operation Theater Tech,BVSC Grad

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Medical Coding Job For 15-24 Passout Nursing,Staff Nurse,GNM Graduate

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Jobs For Biochemistry,Bioinformatics,Biology in Hyderabad

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Jobs For Staff Nurse Freshers

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Physiotherapist Jobs Freshers in Chennai

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

BSc Nursing,B Pharm,Pharmacy Graduate Jobs in SIVAKASI & Chennai

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Wanted MLT Graduates

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Medical Coder -Jobs For Biotech,Biotechnology Engineers,Biomedical Engineers

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Vacancies For Physiotherapy,Physiotherapist,BPT,MPT Graduates in Chennai

Achievers Spot

  • Experience 0 - 1 yrs
  • Salary 4.0 Lac/Yr
NanotechnologyOperations AnalystOperation Theatre TechnicianVeterinary NurseOperation TheatreMedical CodingMedical CoderHome ScienceEnvironment ExecutiveOptometristMedical Coding TraineeMedical Coding FreshersBDSBhmsBvscWalk in

Related Job Openings

We use cookies to improve your experience. By continuing to browse the site, you agree to our Privacy Policy Terms & Conditions [Seeker]

Got it