At United Health Group, their mission is to help people live healthier lives. To achieve this goal, they are focused on building a modern, adaptable, innovative and inclusive system of health care services.
Their scale and potential to improve health makes them one of the most visible stewards of America’s vast health care system. Entrusted with both important resources and responsibilities, they are involved on a daily basis in decision-making that has life-changing consequences for millions of Americans.
Post : Deputy Manager
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.
Primary Responsibilities:
- Plan, develop, and manage the quality and productivity of Production (Claim) teams
- Coordinate project(s) issues with the Service Delivery Leader
- Align with key business partners to serve customers
- Foster/maintain a collaborative relationship with internal and external customers to ensure satisfaction and profitability
- Work with business partners to identify ways to improve business processes
- Assist in building, review and adhere to the annual business plan
- Control expenses and increase profitability via productivity and quality gains
- Work with the MT’s/AM’s and teams to ensure performance commitments are met and ensure teams are meeting production and quality metrics
- Ensure the Production Team and Supervisors continually improve their performance and meets Service Level Agreements/Performance Guarantee goals
- Review work results of the team and their pattern of handling claims queues and adjustments
- Develop, motivate, and retain employees and challenging the team to set ambitious goals
- Provide regular performance feedback and giving frequent formal and informal coaching sessions
- Promote a high level of commitment to anticipating, understanding, and meeting the needs of each internal and external customer
- Identify and leverage internal networks to complete tasks; present ideas persuasively; gain the support and assistance of others who have a stake in the outcome; and proactively participate in company initiatives Identifies trends and issues and recommend solutions
Candidate Profile
• Graduate in any discipline (Medical background)
• 5+ years people management experience
• Knowledge of US Healthcare and coding
• Attention to detail & quality-focused
Preferred Qualifications:
• Health Insurance knowledge, managed care experience
• Medical record familiarity
• Good Analytical & comprehension skills
• People management skills
Additional Information:
Experience: 5+ Years
Location : Noida, Uttar Pradesh
Industry Type: Pharma/ Biotech/Clinical Research
End Date: 10th January, 2018
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