Job title: Clinical Analyst

Company: Cotiviti

Job description: Description :

JOB RESPONSIBILITIES

• Perform daily audits on client data for completeness and accuracy of coding utilizing both coding and clinical background to ensure appropriateness for reimbursement
• Respond to provider appeals.
• Respond to client logics and record reviews
• Monitor acceptance rates for assigned clients and assist management in proactively detecting negative deviations.
• Contribute to PCI product by providing feedback to Management/Development Teams on changes to enhance editing and efficiency.
• Reports his/her work performance on a timely basis to the team lead
• Works diligently to meet and exceed productivity and quality benchmarks
• Takes charge of ongoing learning and development and participates in relevant training and development activities

ATTRIBUTES AND BEHAVIORS

• Develops and maintains positive working relationships with others
• Shares ideas and information Ability to collaborate efficiently.
• Assists colleagues unprompted
• Takes pride in the achievement of team objectives
• Has credibility with peers and senior managers
• Self-motivated – driven to achieve results
• Works with a sense of urgency
• High customer service ethic – is passionate about meeting customer expectations and improving service levels
• Keeps pace with change – acquires knowledge/skills as the business evolves
• Handles confidential information with sensitivity.
• Exhibits behaviors consistent with Cotiviti Values:

• Integrity
• Passionate Client Service
• Teamwork
• Accountability
• Performance Excellence
• Continuous Improvement

RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS

• Medical degree (MBBS or BAMS or BHMS or BDS or B.P.Th) with CPC certification(Mandatory)
• Experience in US Healthcare, medical coding, medical billing, RCM health plan operations strongly preferred.

• Possesses knowledge of healthcare claims payment policy and processing – specifically CMS, Medicaid regulations, AAOS, ICD-9, CPT & HCPCS, etc.
• Practical clinical experience working in a hospital/office or nursing home strongly preferred.
• Has general knowledge of medical procedures, conditions, illnesses and treatment practices
• Possesses excellent written and verbal communication skills. Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency
• Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.

SKILLS & COMPETENCIES

• Strong analytical, critical thinking and problem-solving skills
• Excellent verbal and written communication skills
• Be a quick learner and proficient in application of learnings
• Excel proficiency
• Strong organizational skills and adaptive capacity for rapidly changing priorities and workloads
• Ability to work well independently and maintain focus on a topic for prolonged periods of time

Expected salary:

Location: Pune, Maharashtra

Job date: Sat, 23 Jul 2022 03:24:22 GMT

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