Manage

Primary Responsibility
• Review the relevant medical information abstracted from medical records and then analyze the claim
• Knowledge of US Insurance /Medical Claims/US Healthcare is preferable
• In depth knowledge of medical terminology and body systems
• Ability to interpret medical records, correlate clinical knowledge with available medical data to create medical summary as per product guidelines
• Knowledge of Short and Long Term Disability will be an added advantage
• Understanding of lifestyle disorders like diabetes, hypertension, obesity, etc. that complicates the normal line of treatment of fracture/pain/soft tissue injuries (helpful in creating treatment plan and recommendations)
• Able to differentiate subjective and objective findings in medical records.

Education

Experience
• Preferred medical education background –MBBS with Minimum 2 years of experience in reviewing medical records in claim process

Competencies

& Skills
• Review of medical records and abstract relevant information
• Identifying discrepancies, suspicious issues, negligence, and pre-existing comorbidities
• Proficiency in written English and ability to paraphrase without altering the meaning of the medical text
• Computer literacy - Basic IT knowledge and familiarity of operating systems (Windows)
• Basic Knowledge of using Internet, web browser, search engine, Microsoft excel and word
• Preferred Typing skills - 40 words per minute with 90% accuracy

Soft Skills (Desired)
• Adaptability
• Eagerness to learn/flexibility to change
• Openness to feedback
• Team work
• Business Awareness
• Managing self
• Customer focus
• Desire to excel and improve
• Self-motivated, team player
• Problem solving skills
• Analytical ability
• Good Communication written and oral