- Job Role: Healthcare Operations Management-Utilization Management
- Experience (In Years): 12-15
- Job Location: Noida
- Performs non-medical research including eligibility verification, COB, benefits verification and checking of case restriction for offshore management.
- Sort cases by oldest cases first to ensure turn-around time and to be filtered further as per the case assignment
- Validate data/information to be shared to Data Administration Team (stateside) for case completion
- Inter-liaise with Teams that depend on Missing Data and ensure Business requisites are met
Call to MDO office for any missing information to close case or to validate date any source of information
Responsibilities
- Data gathering requires navigation through multiple system applications.
- Maintains accurate and complete documentation of required information that meets risk management, regulatory, and accreditation requirements.
- Pro-actively and consistently applies the regulatory and accreditation standards to assure that activities are reviewed and processed within guidelines.
- Protects the confidentiality of member information and adheres to company policies regarding confidentiality.
- Staffs are monitored for attendance and schedule adherence, productivity and quality of work based from stateside approved quality audit tool.
Qualifications
Graduate 1 - 3 Years
