| Hyderabad Jobs |
| Banglore Jobs |
| Chennai Jobs |
| Delhi Jobs |
| Ahmedabad Jobs |
| Mumbai Jobs |
| Pune Jobs |
| Vijayawada Jobs |
| Gurgaon Jobs |
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| Hyderabad Jobs |
| Banglore Jobs |
| Chennai Jobs |
| Delhi Jobs |
| Ahmedabad Jobs |
| Mumbai Jobs |
| Pune Jobs |
| Vijayawada Jobs |
| Gurgaon Jobs |
| Noida Jobs |
| Oil & Gas Jobs |
| Banking Jobs |
| Construction Jobs |
| Top Management Jobs |
| IT - Software Jobs |
| Medical Healthcare Jobs |
| Purchase / Logistics Jobs |
| Sales |
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| Job Location | Bangalore |
| Education | Not Mentioned |
| Salary | Not Disclosed |
| Industry | Recruitment Services |
| Functional Area | Sales / BD |
| EmploymentType | Full-time |
: Member Identification Performs intake of calls from members or providers regarding services via telephone , fax , EDI Screens requests for appropriate referral to medical services staff Approve services that do not require a medical review in accordance with the benefit plan Performs non- medical research including eligibility verification , COB , and benefits verification Documentation and Communication Maintains accurate and complete documentation of required information that meets risk management , regulatory , and accreditation requirements Promotes communication , both internally and externally to enhance effectiveness of medical management services (e.g. Claim Administrators , Plan Sponsors , and 3rd party payers as well as Member , Family , and Healthcare Team Members respectively) Protects confidentiality of member information and adheres to policies regarding confidentiality Communicate with Case Managers , when processing transactions for members active in this Program Supports the administration of the precertification process in compliance with various laws and regulations , URAQ and/or NCQA standards , where applicable , while adhering to policy and procedures ,
Keyskills :
nursing patientcare documentation delivery oxygen medicalreview riskmanagement customerservice medicalservices medicalresearch medicalmanagement managementservices bpo edi fax cob ites risk pharma taffnurse