Utilization Management Specialist

Clinical Chart Reviewer

Location: Mohan Cooperative, New Delhi

Opening: 10

Required Experience: 2 - 6 years

• Role:
  Back Office Operations

• Industry Type:
  BPO / Call Centre

• Department: Customer Success, Service Operations

• Employment Type: Full Time, Permanent

• Role Category:

  Back
  Office

Education

• UG:
  Other Graduate, B.Sc in Nursing

Key Skills

• Spoken English

• Nursing

• Computer Skills

• Patient Chart Review

• Clinical Documentation

Perks and Benefits: Best in industry

Job description

• Completes audits according to an established audit schedule and audit procedures

• Based on audit findings, provide feedback for opportunities for improvement

• Submits medical record audits within timely manner and completes follow up activities as directed

• Monitors and provides follow up on requested audit corrections by the organization to ensure they have been completed

• Maintains a high level of confidentiality relating to resident information, audit reviews and findings

• Notifies supervisor of any critical incidents identified in the medical record

• Participates in required training sessions and staff meetings

• Performs other duties as requested

Preferred candidate profile

• College nursing degree, Registered Professional Nurse with active license in India

• Minimum 2 years of bedside nursing experience

• 2 years or more of experience in healthcare auditing, preferred

• Ability to work with sensitive and/or confidential information. Knowledge of confidentiality 5aws and healthcare regulatory and compliance (HIPAA) regulations

• Proficient in Microsoft Office especially Word and Excel

• Experience with use of with electronic medical records, preferred

• Ability to learn and adapt quickly, strong attention to detail and prioritize projects appropriately

• Ability to work effectively as a team member and meet time deadlines

• Bi-lingual English (spoken and written)