UnitedHealth Group Information Services
Job Description
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.
-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
Ground Floor
Tower D, 3Cs Oxygen SEZ,
Sector 144, Noida, Uttar Pradesh
Contact Person: Shekhar Singh
Salary: INR 1,25,000 – 4,50,000 P.A. Best in the Industry
Industry: BPO / Call Centre / ITES
Functional Area: Medical, Healthcare, R&D, Pharmaceuticals, Biotechnology
Role Category: Medical Professional
Role: Medical Officer
Employment Type: Permanent Job, Full Time