Job ID 5046
Experience 5-7 Years
Qualifications Bachelor's Degree
- Ability to handle Team.
- Work as reviewer and auditor for creating HEDIS appropriate notes
- To identify and solve the productivity and Quality Issues/ Needs.
- To plan productivity with daily 100% target achievement with rejections below 5%.
- To justify treatment and request the physician intervention as required with proper medical evidence.
- Work closely with Quality improvement team and help if any priority assignments to be completed before deadline.
- Interact and work with managers regarding problem-solving and understanding the process.
- Prioritize workloads to ensure expedited cases are processed within defined timelines.
- Responsible for the timely completion of individual cases and meeting the SLA for data entry and case analysis activity as per SOP.
- Help in recruiting process as Technical Panel.
- Provide process training sessions for new joinee and quality sessions for the entire team
- Expertise in conducting query verification and query audit compliance
- Work assignments and leave management
- Making workflows for any new project or adding updates to the existing projects.
- Conduct Daily and Weekly training sessions and team building/fun activities.