• Health Services Specialist, Medical Assistant Jobs in Ahmedabad,India - 24961604

  • TRS HR SERVICES
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  • 7 - 12 Years
  • Posted : above 1 month

Job Description:


  • Responsible for the auditing of corporate, health plan, and specialty company staff related to clinical systems entry and/or processes


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  • Develop and maintain the audit process and tools related to authorizations, appeals, quality events, and case management in CCMS; interrater reliability related to InterQual; and data entry into the credentialing subsystem

  • Develop and maintain the audit schedule

  • Audit staff as outlined in the system auditing policies

  • Train audit staff at the health plan in the use of audit process and tools

  • Facilitate compliance with the auditing process

  • Act as a consultant related to system auditing to others in the unit, department and health plan

  • Work with staff to identify and resolve authorization load error report system problems

  • Coordinate auditing outcomes with the Trainer to identify, develop and publish corrective actions/educational material related to audit errors

  • Coordinate auditing outcomes and system maintenance with the Sr Clinical Systems Specialist to resolve or enhance clinical systems
  • Profile Summary:

    Employment Type : Full Time
    Eligibility : Any Graduate
    Industry : Biotechnology/Pharmaceutical/Medicine, Healthcare
    Functional Area : Bio Tech/R&D/Scientist, Doctors/Nurses/Medical Professional
    Role : Forensics,Lab Staff,Nutrition,Critic al Care
    Salary : Best in Industry
    Deadline : 06th May 2020

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