Sanjay Nagar Bengaluru Karnataka Medical director Jobs – 263 Open Jobs Today

Medical Claims Review Senior Analyst
The Cigna Group —Bengaluru, Karnataka
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- Medicine
- Microsoft Access
- Microsoft Outlook
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Sr. Mgr/Director of Product Management
Quickbase —Bengaluru, Karnataka
- Full-time
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ALSTOM —Bengaluru, Karnataka
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MOBILITY INDIA —Bangalore City, Bengaluru, Karnataka
- Up to ₹1,75,000 a month
- Full-time
- Master's degree
- Business development
- Bachelor's degree
- Health insurance
- Life insurance
Quick apply
Director - CDD
Alvarez & Marsal —Bengaluru, Karnataka
- Master's degree
- Project management
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Finance Director
Gensler —Bengaluru, Karnataka
- Full-time
- Administrative experience
- Analysis skills
- Travel
- Paid holidays
- Health insurance
Director - AIG
Alvarez & Marsal —Bengaluru, Karnataka
- Full-time
- Public speaking
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Sr. Director & Head of Architecture
G-P —Bengaluru, Karnataka
- Full-time
- Remote
- Computer Science
- Master's degree
- AWS
- Health insurance
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Senior Director Design Manager
Analog Devices —Bengaluru, Karnataka
- Full-time
- B.Sc
- Master's degree
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Junior Project Manager – Health & Wellness
Resolute AI —Bangalore City, Bengaluru, Karnataka
- Full-time
- PMP
- Master's degree
- Project management
Quick apply
13d
Director - RCM
Calpion —Bengaluru, Karnataka
- Email
- AutoCAD
- Management
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Senior Manager - Medical Data Review
Novo Nordisk —Bengaluru, Karnataka
- Medicine
- English
- Leadership
Associate Director, Application Development
RSM —Bengaluru, Karnataka
- Full-time
- Azure
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5d
Director, Quality Assurance
LG Ad Solutions —Bengaluru, Karnataka
- Email
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Senior Delivery Manager / Delivery Lead
Accellor —Bengaluru, Karnataka
- Full-time
- Remote
- Azure
- PMP
- AWS
- Health insurance
- Paid time off
Quick apply
Director of Recruiting, Engineering & IT, Bangalore India
GitLab —Bengaluru, Karnataka
- Full-time
- Machine learning
- Recruiting
- AI
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- Paid time off
4d
Director of Engineering, Organizations & Cells
GitLab —Bengaluru, Karnataka
- Full-time
- AI
- Communication skills
- Health insurance
- Paid time off
Director - Process Excellence & Transformation
Fresenius Medical Care —Bengaluru, Karnataka
- Full-time
- Childcare
- PMP
- English
- Flexible schedule
Personal Secretary
CUTIS - Academy of Cutaneous Sciences —Vijayanagar, Bengaluru, Karnataka
- ₹40,000 - ₹50,000 a month
- Full-time
- Medicine
- English
- Master's degree
- Food provided
Quick apply
13d
Marketing & Communication Director 1
RSM —Bengaluru, Karnataka
- Full-time
- Marketing
- Analysis skills
- Bachelor's degree

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Medical Claims Review Senior Analyst

The Cigna Group -
Bengaluru, Karnataka

Apply Now

Job details

Full-time
1 hour ago

Qualifications

Medicine
Microsoft Access
Microsoft Outlook
Research
MBBS
Microsoft Office
Clinical experience
Quality assurance
Bachelor's degree
SharePoint
Fraud prevention and detection
Communication skills
Time management

Full job description

Medical Claims Review Senior Analyst/Clinical supervisor – Complex Claim Unit

Provides clinical review expertise for high dollar and complex claims, including facility and professional bills. Provides cost containment services by identifying coding and billing errors and insuring application of Medical and Reimbursement Policies. Additionally identifies cases for potential fraud and abuse and makes referrals.

Major Job Responsibilities

Evaluates medical information against criteria, benefit plan, coverage policies and determines necessity for procedure and refers to Medical Director if criteria are not met
Evaluate itemized bills against reimbursement policies
Adheres to quality assurance standards
Serves as a resource to facilitate understanding of products
Handles some escalated cases; secures supervisory assistance with problem solving and decision making
Advises supervisory staff of any concerns or complaints expressed by Health Care Professionals
Utilizes effective communication, courtesy and professionalism in all interactions, both internally and externally
Performs additional unit duties below as appropriate:
Participate on special projects.
Perform random or focused reviews as required.
Support and assist with training and precepting as required
Analyze clinical information
Perform claim reviews with focus on coding and billing errors
Identify and refer cases for possible fraud/abuse or questionable billing practices to the appropriate matrix partners
Handle multiple products and benefit plans
Works under moderate direct supervision

Qualifications

MBBS
Maintain active Medical as required by state and company guidelines
Clinical experience in hospital/clinic for 3 or more years
Team player
Flexible/Adaptable
Excellent time management, organizational, and research skills
Experience with MS Office Suite (Outlook, Excel, Access, SharePoint)

Preferred Qualifications

Utilization Review or Claim Review experience in Health insurance
Knowledge of the Principles of Health Care Reimbursement

Key Skills and Competencies

Strong background in quantitative decision making, ability to drive business/operations metrics
Metrics-driven. Able to translate strategy into measurable operational goals and objectives. Disciplined in assessing performance and addressing problems.
Good communication and strong interpersonal skills.
Highly organized, structured proactive.
Good inter-cultural skills Exposure to global work environment.
Good time management skills - meet tight timelines and manage ad hoc deliverables, if any.

About The Cigna Group

Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.

Apply Now

Refine Your Search

medical director jobs in sanjay nagar bengaluru karnataka

Medical Claims Review Senior Analyst

Sr. Mgr/Director of Product Management

Department Director

Executive Director

Director - CDD

Finance Director

Director - AIG

Sr. Director & Head of Architecture

Senior Director Design Manager

Junior Project Manager – Health & Wellness

Director - RCM

Senior Manager - Medical Data Review

Associate Director, Application Development

Director, Quality Assurance

Senior Delivery Manager / Delivery Lead

Director of Recruiting, Engineering & IT, Bangalore India

Director of Engineering, Organizations & Cells

Director - Process Excellence & Transformation

Personal Secretary

Marketing & Communication Director 1

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