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J0691 : Power BI Developer RCM Analytics
SKILLS REQUIRED
? Power BI
? SQL server.
? ETL
? Knowledge of Microsoft BI Stack
? Grip over data analytics
Roles And Responsibilities:
? Design, develop, and maintain interactive and visually compelling Power BI dashboards effectively with complex data from various sources
? Establish secure and efficient connections between Power BI and backend systems.
? Ability to perform end-to-end automation with minimal/no manual intervention
? Understand requirement thoroughly, document, develop, maintain the dashboards
? Expert in using advanced-level calculations on the data set.
? Experience in databases like SQL server, Databases etc.
? Strong knowledge in DAX.
? Integrate data from multiple sources to produce requested or required data elements.
? Create customize charts and custom calculations as per requirement.
? Very good communication skills - Must be able to discuss the requirements effectively with the teams
? Knowledge of Power Pivot is an advantage
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J0690 : Team Leader - HIM
Any graduate.
Good communication.
Good analytical skills.
Open to rotational shifts.
Prior experience in any healthcare process with hands on experience on:
1. Team handling.
2. People management.
3. Process management.
4. Leave and attendance management.
5. Inventory management.
6. Quality management.
Candidates with 5+ years of experience in Medical Transcription, Legal Transcription, Medicolegal Summarization, Medical Scribing, etc. also preferred.
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J0689 : Associate - Non Core Measures
Position: Executive Education: Pharm D; Bsc Nursing; Experience: 0- 3 years
Skills: Good Clinical knowledge, detail oriented.
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J0688 : Associate - Core Measures
Position: Executive Education: Pharm D; Bsc Nursing; Experience: 0- 3 years
Skills: Good Clinical knowledge, detail oriented.
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J0687 : Cyber Security - Specialist ~ IR/Forensics
• Bachelor's Degree in Information Systems, Computer Science, or related field or equivalent or an equivalent number of years of experience
• 5+ years of experience in Digital Forensics and Incident Response
• The successful applicant must possess one or more current, applicable professional/technical certifications, such as Certified Information Systems Auditor (CISA), Certified Information Security Manager (CISM), Certified Security Compliance Specialist (CSCS), Certified Information Privacy Professional (CIPP), Certified Information Systems Security Professional (CISSP), Certified Internal Auditor (CIA), GPEN, GWAPT, SANS GCFA/GCFE/GSEC/GCIA/GCIH/GREM/GNFA, EnCE, CHFI, CEH, ECIH
• Knowledge of Cyber Security management practices, network, and application vulnerability assessments, change control, business continuity planning, data privacy, and risk assessment practices
• Proficiency with EnCase or any other forensic tool such as FTK, X-Ways, etc.
• Experience with network packets/traffic analysis using tools like Wireshark, tcpdump, Zeek, tshark, SiLK, etc.
• Experience hunting threats using SIEM and other detection platforms
• Proficiency with Windows and *nix OS platforms
• Experience in Incident Investigation and reporting relevant facts
• Experience in memory analysis using tools like Volatility, Rekall, etc.
• Experience using platforms/distributions like SIFT, Remnux, FLARE, etc.
• Experience with basic static and dynamic/behavioral malware analysis. Advanced static and dynamic analysis experience would be a plus.
• Scripting skills are a plus
• Knowledge of TCP/IP communications and how common protocols (SMTP, HTTP, POP3, IMAP, etc.) and applications work at the network
• Ability to demonstrate analytical expertise, close attention to detail, excellent critical thinking, logic, and solution orientation and to learn and adapt quickly
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J0684 : Sr. Associate
• Perform Eligibility check to determine the Coverage dates and Patient responsibilities
• Insurance calling to perform Eligibility check for the payers that do not have option to check in their portals
• Download the Eligibility copy and Index to patient account
• Validate Patient demographics in EMR matching with patient details updated with payer
• Validate Insurance details in EMR matching with details updated with payer
• For patient accounts with “No coverage details updated”, perform Self-pay research
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J0683 : SME - AR - Special Projects
Reviewing daily 277, denial reports and working towards the process improvement activities
Highlight potential issues from the Denial report
Work closely to create DOFR instructions for all California projects
Work with the automation team to submit claims automatically to the responsible payer
Monitor claim submissions, 277 acknowledgments, and denials from the payers to revisit if there are any necessary changes to the automation process
Develop recommendations for corrective action based on the analysis of the reports
Ability to work in a fast-paced environment and meet deadlines
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J0682 : HCC Query Finalizer
To review the HCC Queries to validate the query eligibility and supporting clinical evidences based on patient's historical Medical Records
Optimize the query templates before submitting to the Physicians with appropriate coding & clinical knowledge
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J0681 : RCM Trainer
Roles and Responsibilities
• Must train new hires on process specific
• Monitor the progress of the trainees and provide constructive feedback during OJT phase
• Coaching the trainees on short falls and track their improvements
• To be a good motivator and maintaining the team performance
• Responsible for creating and administering training programs for new hires and existing employees
• Excellent time management also flexible with shift timings.
• Content development and management
Skills/ Competencies
• Good Communication and interpersonal Skills
• People Management
• Microsoft Office
• Strong knowledge on HB terminologies
• Expertise in Contracts Reimbursement methodologies
• Denial management
• Good Presentation Skills
Must have minimum 5 years of experience in RCM and should be working as a process trainer/training specialist in the current role
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J0680 : ETL Test Engineer
An ETL (Extract, Transform, Load) tester is a professional responsible for testing the ETL processes and workflows in a data integration project. ETL testing involves verifying the accuracy, completeness, and reliability of data as it is extracted from various sources, transformed according to business rules, and loaded into a target database or data warehouse.
The primary role of an ETL tester is to ensure that the data integration process is functioning correctly, and that the data being transformed and loaded meets the expected quality standards. Here are some key responsibilities and activities performed by an ETL tester:
Test Planning: Creating test plans and strategies to define the scope, objectives, and approach for ETL testing.
Data Validation: Verifying the accuracy and integrity of data by comparing the source data with the transformed data at different stages of the ETL process.
Data Completeness: Checking whether all the expected data from the source systems is successfully extracted and loaded into the target system.
Data Transformation: Testing the business rules and transformation logic applied to the data during the ETL process to ensure that it meets the expected outcomes.
Error Handling: Validating how errors, exceptions, and data quality issues are handled within the ETL workflows, including error logging, data rejection, and exception handling mechanisms.
Performance Testing: Assessing the performance and scalability of the ETL processes, including data extraction, transformation, and loading speeds.
ETL testers typically work closely with ETL developers, business analysts, and data engineers to understand the ETL requirements, design specifications, and data mappings. They use a combination of manual testing techniques and automated testing tools to perform ETL testing effectively. Strong SQL skills, data analysis abilities, and a good understanding of data integration concepts are essential for an ETL tester to be successful in their role.
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J0678 : AR SME - Technical Appeals
AR specialist who works on appeals is responsible for managing and facilitating the appeals process for healthcare claims. Their primary role is to review denied or underpaid claims, identify reasons for denial or underpaid, gather necessary documentation, and prepare appeals on behalf of facility.
Here are some key responsibilities and tasks typically associated with the job:
1. Reviewing denied claims: The specialist examines claims that have been denied by insurance companies or other payers to understand the reasons for denial. They carefully analyze the claims, payer policies, and relevant medical documentation to identify potential grounds for appeal.
2. Researching regulations and policies: Healthcare specialists stay updated on the latest regulations, payer policies, and guidelines pertaining to claim denials and appeals. They thoroughly research the applicable regulations and policies to ensure that appeals are constructed based on accurate and relevant information.
3. Collecting supporting documentation: The specialist works closely with other involved parties to gather the necessary medical records, documentation, and any other supporting evidence required to strengthen the appeal. They ensure that all relevant information is properly documented and organized for submission.
4. Preparing appeals: Based on their analysis and understanding of the denial or underpaid reasons, the specialist develops persuasive arguments and constructs well-written appeals. They prepare detailed appeal letters or forms, outlining the medical necessity, appropriate coding, and any other relevant information to support the case.
5. Following up on appeals: After submitting the appeals, the specialist tracks the progress of each case, ensuring that deadlines are met and appropriate follow-up actions are taken.
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J0677 : Medical Coder - Inpatient Coding
Inpatient medical coding specialist with good comprehension of medical records review and abstraction of Dx and PCS codes adhering to IPPS (Inpatient Payment Prospective System).
IPDRG Coding experience with CPC or CCS certification
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J0676 : Utilization Management - Reviewer
Required good clinical knowledge with good communication and writing skills. Need to prepare clinical summaries on daily basis.
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J0673 : Medical Records/ Appeal tech
Medical Records resources and ADR reviewers for RAC Appeals Team
Education: B. Pharm & Graduate in any life science background
Experience: Minimum 1 year of experience in healthcare
Skills: Good Clinical Knowledge, Flexible to work in rotational shifts, Good communication skills, basic computer knowledge with good typing speed.
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J0671 : Sr MIS Analyst
Sr MIS Analyst :Education: B.tech or any Degree.: Experience: 2-4 Years
Skills: Excel Knowledge at advance Level and SQL Basics, Good Communication skills.
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J0670 : Sr MIS Analyst
Sr MIS Analyst :Education: B.tech or any Degree.: Experience: 2-4 Years
Skills: Excel Knowledge at advance Level and SQL Basics, Good Communication skills.
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J0669 : Quality Analyst
Good with Denial management
Good understanding of the entire RCM cycle to improve the first pass resolution.
Able to deliver effective feedback.
Should be able to identify global trends and patterns.
Good Communication and Interpersonal Skills, Good team Player
4+ years of experience in AR/EVBV
Minimum 1 year working as Quality Analyst
Good MS Excel knowledge
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J0668 : Quality Analyst
Good with Denial management
Good understanding of the entire RCM cycle to improve the first pass resolution.
Able to deliver effective feedback.
Should be able to identify global trends and patterns.
Good Communication and Interpersonal Skills, Good team Player
4+ years of experience in AR
Minimum 1 year working as Quality Analyst
Good MS Excel knowledge
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J0666 : DRG Finalizer &^ CDS Reviewer
Clinical interpretation of medical diagnosis and literature to Improve the documentation quality.
Assigning & Auditing the ICD(International Classification of Diseases) codes based on the available clinical documentation for claim submission.
To identify the missed diagnosis and clinically validate the existing diagnosis for every patient abstract.
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J0659 : Appeal Specialist RAC- Medicare & Medicaid Appeals
Position: Appeal Specialist
Education: MBBS, BHMS, BAMS, MDS (With clinical experience)
Experience: Minimum 1 year of experience in Clinic, 0-2 years in healthcare
Skills: Good Clinical Knowledge, Flexible to work in rotational shifts, Good communication skills, basic computer knowledge with good typing speed.
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J0656 : Quality Analyst
Good with Denial management
Good understanding of the entire RCM cycle to improve the first pass resolution.
Able to deliver effective feedback.
Should be able to identify global trends and patterns.
Good Communication and Interpersonal Skills, Good team Player
4+ years of experience in AR
Minimum 1 year working as Quality Analyst
Good MS Excel knowledge
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J0655 : TL/AM/DM PMO-AR(M7 Team)
Should have 7 to 12+ years' experience in the US Health Care, provider side business.
Has a thorough understanding of the RCM process and has demonstrated work experience in handling hospital AR business
Analyze complex healthcare data and communicating insights to stakeholders.
Collaborate with teams to support decision making and improve healthcare outcomes.
Strong analytical skills, familiarity with healthcare data sources
Excellent communication skills, detail-oriented, and have an analytical mindset and the ability to work within a multidisciplinary team environment.
Focus to improve the quality and efficiency of healthcare delivery and contribute towards impactful outcomes.
Should have good working knowledge in working on MS-Excel (Proficiency level = Advanced
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J0651 : Insurance follow up - AR
PB & HB experience required with Min 2 years Exp. Good Account Analysis, Sound knowledge on Auth denials/Criteria from the Health Plan. Training (1 month) from office and will be shifted to work from home post OJT.
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J0642 : Cyber Security ~ Specialist (EP - L2)
• Perform regular administrative task such as verifying EPO master server and Distributed repository, VSE, ENS and McAfee endpoint specific event log monitoring, definition distribution Verification and health check of repositories. Pro-active management of ePO\VSE\ENS\DLP\HIPS\EEPC issues and events.
• Meet SLA s by processing requests to resolve endpoint security issues with workstation support and end users which also includes exception/ exclusion handling
• Provide desktop and technical expertise to the Security Services Team.
• Provide technical support in evaluating, designing, implementing, and supporting a McAfee endpoint and other advanced endpoint protection environment
• Ensure all policies and procedures are followed, work within the scope of the project, and adhere to time constraints.
• Conduct appropriate analysis and work with appropriate resources to ensure issues are addressed in a timely manner. Issues that are unable to be resolved should be appropriately forwarded to vendor product support, and followed through to resolution.
• Compliance policy configuration and troubleshooting
• Evaluate, implement, roll- out, and endpoint security solutions.
• Manage and execute on projects within the team and cross- functionally.
• Perform root cause analysis to resolve issues quickly in a complex IT environment.
• Follow policies and procedures including those for ITIL incident, problem, change, and release management.
Required Skills and Experience:
• Candidate should possess minimum 5+ Years of Experience in Endpoint Security/IT Operational Security having minimum of 3 years of experience in Managing and Supporting McAfee ePolicy Orchestrator, Virusscan Enterprise, Data Loss Prevention, Host Intrusion Prevention and Endpoint Encryption.
• The requirement is to support the McAfee ePO environment with strong McAfee Endpoint Security suite policy configuration and deployment support.
• Candidate should be a Subject Matter Expert with in-depth knowledge of implementation, and operational support, administration surrounding the process supporting the business for End-User Enabled Security technologies/initiatives specifically on McAfee endpoint security
• The candidate should have a solid understanding of end-user Endpoint technologies, complete understanding of McAfee Endpoint policies, their strengths, weakness and applicable usages.
• Should have good Work Experience on Infrastructure Security Domain mainly on McAfee Endpoint products.
• Operational experience on components like McAfee Agent, VSE, HIPS, ENS, TIE, DXL, FRP, MDE, MAR, and MOVE products.
• Ability to create VBscripts to use for asset searching and automation.
• Define and configure McAfee Endpoint Security policies including AV on access and on demand scanning, firewall, access protection, intrusion prevention, queries and use of ePO policy and client task assignment with tags.
• Must have advanced trouble shooting skills to identify the severity of the issue, ability to resolve issues quickly to account/customer satisfaction and Prepare RCA.
• High Severity Incident Analysis, incident trend report, and create new policy and reports
• Good knowledge/understanding on Threat Analysis.
• Good working knowledge/understanding on Data loss prevention and Endpoint Encryption tools
• Should have knowledge in handling Major Virus outbreaks/Major incidents
• Excellent customer handling skills along with extensive hands on skills in defining and creating operational/procedure documents.
• Possess knowledge on ITIL processes like Incident Management, Problem Management, Configuration Management and Change Management processes
Preferred Certification:
• McAfee Product Specialist
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J0640 : EOB Review
Position: Sr Associate
Education: Minimum Graduate in any stream
Experience: a) 18+ months in US health care RCM process b) Experience in Payment posting (Hospital is preferable)
Skills: a) Payment posting, b) Credit balance, c) Contracts review d) Expected reimbursement calculation e) strong Knowledge of EOBs/835 f) Fair knowledge of Denials
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