Client Management Lead at Edge Executive Search
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Consultant - Healthcare Vertical - Technology & Consulting Firm - MD/MPH (5-12 yrs)
The Company :
India's marquee global technology & consulting company. They are an international flag-bearer of technical and managerial excellence. With offices around the globe, the company has a comprehensive presence across multiple segments of the technology product and service industries as well as a blue-chip roster of clients for their Consulting engagements. They are a respected career company and a long-term wealth creator.
The Job :
- Proficient in reviewing medical records to interpret clinical documentation and assess accuracy
- Demonstrated experience working with ICD10 guidelines, CPT, HCPCS classification system, DRGs
- Possess an understanding of claims data, including ICD-10 & CPT codes, DRGs, health status, Risk Adjustment Factor (RAF), and other risk adjusters
- Knowledge of insurance and payment methods- Medicaid, Medicare, value-based payment models, managed care risk contracts, and ACO operations
- Drive development of solution propositions, prototypes, POCs based on competitive intelligence and industry trends
- Conduct domain-focused trainings across the organization
- Should be able to work in cross functional teams comprising engineers, data scientists, statisticians etc.
- Candidate should be self-driven with keen critical thinking, analytical abilities, flexibility, adaptability to work schedules, effective verbal & written communication, time management, self-confidence, open to changes & challenges, detail-oriented, with sound independent decision making.
- Should be able to work in cross functional teams comprising engineers, data scientists, statisticians etc.
Your Profile :
We are looking for medicine graduates(MBBS/MD/MPH) keen to empower healthcare payers and providers to quickly process medical data in making informed decisions and overall reduce health care costs. you should be well versed in the US healthcare ecosystem with a deep understanding of the spectrum of payer business processes including medical coding, billing, auditing, compliance, and clinical documentation improvement.
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