Associate Consultant

Infosys; Mangaluru; On-site; INR 800,000 - 1,400,000; Full time

Job summary

Infosys Limited is seeking an Associate Consultant with 5-9 years of experience to perform medical necessity reviews, data management, and reporting for US healthcare clients. The role emphasizes analytical skills, familiarity with coding (ICD/CPT), and strong collaboration with clients to drive data-driven decisions.

Responsibilities include clinical review of authorization requests, understanding utilization management and Milliman guidelines, and contributing to process improvements using

Qualifications

• Graduate degree required.
• Experience in clinical data management or healthcare operations preferred.
• Knowledge of US healthcare processes and regulations is a plus.

Responsibilities

• Perform medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in line with regulatory guidelines and SOPs.
• Analyze authorization requests to determine medical necessity and service appropriateness.
• Familiarity with Milliman guidelines and utilization management concepts is desirable.
• Knowledge of ICD and CPT coding.
• Collaborate with clients to identify challenges and refine data for deliverables.
• Identify process improvements and propose technology solutions.

Skills

Training

Data Management

Reporting

Quality Tools

Descriptive Analysis

New Project Implementation

Education

Graduate

Tools

Microsoft Word

Excel

Computer Navigation

Typing

Communication Skills

Job description

Job ID/Reference Code

PROGEN-EXTERNAL-255409

Work Experience

5 - 9 Years

Job Title

Associate Consultant

Educational Requirements

Graduate

Service Line

BPO Service Line

Responsibilities

Senior SME Skillset: Training, Data Management and reporting, Quality Tools, Descriptive Analysis, New project Implementation- Perform medical necessity and clinical reviews of authorization requests to determine medical appropriateness of care in accordance with regulatory guidelines and Standard Operating procedures- Clinical knowledge and ability to analyze authorization requests and determine medical necessity of service preferred.- Good understanding of US healthcare business- Knowledge of utilization management processes (preferred)- Ability to understand Milliman guidelines (preferred)- Knowledge of managed care, acute care, emergency room, cardiology, radiology, etc- Understanding of ICD and CPT codes

Additional Responsibilities

• Ability to work with clients to identify business challenges and contribute to client deliverables by refining, analyzing, and structuring relevant data
• Awareness of latest technologies and trends
• Logical thinking and problem solving skills along with an ability to collaborate
• Ability to assess the current processes, identify improvement areas and suggest the technology solutions
• One or two industry domain knowledge

Technical and Professional Requirements

Primary skills: Operations->Clinical Data ManagementMicrosoft Word, Excel, Computer navigation, typing skills, effective communication skills, both verbal and written