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Achievers Spot in Chennai is seeking fresh graduates to join its medical review team. The role focuses on utilization management, reviewing medical records, and adhering to URAC and client protocols to ensure timely processing.
You will respond to inbound calls, coordinate with the management team, learn new services, and support utilization management programs while maintaining quality and regulatory standards.
Life Sciences, Paramedical Technician, Life Science, Paramedical, Pharmacy, Physiotherapist, Nurse, Staff Nurse, Biotechnology, Biomedical Engineer, Bioinformatics, Biochemistry, Microbiology, Biology, Zoology Botany, Anesthesiology, BDS, Bhms, Bams, Bsms, Pharmacist.
Hospitals / Medical / Healthcare Equipments
Health Care / Pharmaceuticals / Medical
50
0 - 1 Yrs.
INR 325000 - 400000
Chennai
Graduate (BDS, B.Pharma, B.Sc, B.Tech/B.E, BVSC)
All
Own Company
Mailing Email ID - meena@achieversspot.com
This Role is Open to Fresh Graduates with Excellent English Communication Skills. Adhere to Utilization Review Accreditation Commission (URAC), jurisdictional, and/or established MediCall best practice UM time frames, as appropriate. Provide succinct negotiable points based on the submitted medical records that identify necessary medical treatment, casually related care, response or lack of response to treatment, etc. Identify missing records and information that are necessary in the completion of the medical review assessment. Adhere to Department of Labor, state and company timeframe requirements. Track status of all utilization management reviews in progress and follow up on all pending cases. Work closely with management team in the ongoing development and implementation of utilization management programs. Respond to inbound telephone calls pertaining to medical reviews in a timely manner, following client a established protocols. Process customer calls consistent with program specified strategies and customer satisfaction measurements to include but not limited to proper answering procedure, eg opening and closing remarks. Learn new methods and services as the job requires.
You have At Least a Diploma/degree in Any Field. Such as Biotechnology, Biomedical Engineer, Biochemistry, Microbiologist, Biotechnologist, Biology,
Identify missing records and information that are necessary in the completion of the medical review assessment. Adhere to Department of Labor, state and company timeframe requirements. Perform medical review assessment (MRA) on utilization of health services (eg healthcare plans, workers compensation products etc) in an accurate, efficient and timely manner while ensuring compliance with utilization management regulations and adherence to state and federal mandates.
Lavanya 9566157632