| Company: | Cognizant |
|---|---|
| Job Role: | Process Executive-Voice |
| Experience: | Freshers (0-1years): |
| Vacancy: | 3+ |
| Qualification: | BE/BTech,MCA, Bachelor degree in Nursing or Any health science related field. |
| Salary: | UptoRs.25000 |
| Location: | Chennai India |
| Join us on Telegram | Click Here |
| Apply Mode: | (Online) |
| Start Date: | 27-08-2021 |
- Business/Customer:
- Information Processes:
- • Provide most elevated level of consumer loyalty.
- • Strive to comprehend and resolve issues/questions at the principal case.
- • Maintain the business controls according to the prerequisite.
- For NA, Medical Management and Benefit Coding:
- • Respond to information asks for and produce clientspecified reports in an opportune way.
- • Articulate/convey in a way which is perceived by customers/endusers.
- Cases, RCM and Member Services:
- • Efficiently Process predefined number of cases/enlistment as relegated with most significant level of precision as settled upon by the customer.
- • Escalating the issues recieved in various clusters.
- • Supporting the group to accomplish the SLA and TAT related with Correspondence, Payments, PIA, and Write off.
- • Delivering the quality measurements as characterized by Customers.
- For Claims, RCM and Member Services:
- • Make and Answer calls to and from clients/end clients dependent on concurred time periods.
- • Transfer calls including next degree of administration to the suitable division according to the given rules.
- • Develop a total comprehension of the Procedures.
- • Complete exchanges for information readiness, entries, and so forth as characterized in Sop's.
- • 100% Process adherence to exchange handling timetables.
- • Adhere to review consistence ( SAS 70, SOX, Statutory Audit) of all cycles as spread out in measure documentation.
- • Ensure measure rules are followed and met as recorded.
- • Set efficiency/Quality benchmark.
- • Adhere to move handover measures.
- • Raise measure related issues/worries on schedule with cycle and group leads.
- • Ensure to meet all Statistical, Financial and TAT measurements.
- • Stay refreshed with the interaction information/changes allude to information refreshes/vaults to successfully handle exchanges.
- • Adhere to security rehearses set by association.
- • Provide refreshes and submit reports identified with own space of work.
- • Complete exchange/calls volumes in line inside determined Turn Around Time.
- • Respond to information demands.
- • Perform managerial obligations which incorporates keeping up with precise records of data in regards to got claims/treatment demands.
- • Record information identifying with creation measurements, enduser related notes, and so forth as suitable.
- • Maintain secrecy of all data, strategies, and techniques as needed by the Health Insurance Portability and Accountability Act (HIPAA) conventions.
- • Raise measure related issues/worries to group drives/supervisor.
- • Adhere to government, state, URAC, clientspecified, and set up accepted procedures in regards to use the board.
- • Adhere to program quality guidelines and keep up with adequate degrees of execution, including yet not restricted to participation, adherence to conventions, client graciousness, and any remaining usefulness and proficiency targets and goals.
- • Continuous commitment to handle greatness/improvement.
- • Participate in task and association drives drove by the Delivery initiative.
- • Receive, login and record an assortment of reports, customer graphs, customer cooperations and different archives depending on the situation in the record.
- • Efficiently get ready and additionally relegate a predefined number of cases/exchanges with most elevated exactness.
- • Prescreen a case/treatment demand for culmination and decide whether this is fitting for additional preparing.
- • Sort, transfer and relegate the case/treatment solicitation to a case director, nurture commentator or doctor analyst.
- • Follow up on all forthcoming cases fittingly and start the subsequent stages.
- • Input enlistment/change information in an ideal way to concur with communication to merchants and area finance.
- • Process claims archives with zero basic mistakes.
- • Manage benefits documentation by collecting advantage parcels, recording benefits administrative work.
- • Read and investigate the Benefit Grid/Source archive, comprehend the advantages and code something very similar in the application.
- • Works on Blue Exchange, Benefit Narratives and related line of organizations.
- • Follow up on all forthcoming cases suitably and start the subsequent stages.
- • Complete exchanges for claims entries, dismissals, Payment posting as characterized in Sop's.
- • Complete coding exchanges with the necessary ICD, CPT and different prerequisites.
- • Respond to information demands.
- • Process claims, accuses and coding of zero basic mistakes.
- • Review and examination of the supplier application for fulfillment and precision.
- • Perform confirmation of information through supported sources recorded by the customer.
- • Collect all appropriate data from the supplier, supplier's misbehavior guarantor, National Practitioner Data Bank (NPDB) and different sources as recorded by the customer.
- • Receive and cycle new and recharging accreditation applications for an assortment of qualifications, endorsements, Permits and waivers.
- • Make efforts to suppliers to gather missing/obsolete data.
- • Manage Inventory and work on records that require numerous subsequent meet-ups with the supplier.
- • Process enlistment reports with zero basic blunders.
- • Complete enlistment or disenrollment/question calls exchanges in line inside determined Turn Around Time.
- • Develops, facilitates, and executes project plans.
- Individuals/Team:
- • Contribute to and take part proactively in information sharing meetings.
- • Completes all required evaluation/certificates as relevant.
- • Align individual objectives with group targets (work firmly with the group).
- • Participate and add to hierarchical exercises.
- • Record own participation and time sheet related information.
- • Builds and keeps a durable cross association/organization project group ethos and encourages useful working connections, ideally allotting undertakings to colleagues.
- For NA:
- • Contribute towards refreshing information resources, client manual, online assistance report.
- • Contribute to groups Learning and information improvement programs.
- Clamis
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