Clinical Analyst @ EXL ..R

 

Clinical Analyst @ EXL Services.com ( I ) Pvt. Ltd

Job Description

Position Title

Medical Claim Summarizer

Function, Responsibility Level

Operations, Executive

Basic Function

Medical Claim Summarizer will be responsible for reviewing and summarization of medical records.

Review Incident / Accident description. Review alleged Injuries. Note Date of Loss

Essential Functions

Sort Medical Records

1. Receive records digitized and with referral and cover sheet for each case and docketed under matter number

2. Removing bills or medical fee statements (to be kept together separated from main records)

3. Remove forms (kept together designated as not relevant)

4. Arrange records in order by Provider, then by date of treatment

5. Remove all duplicate, triplicate etc. records and reports (place with other not relevant sheets)

6. Remove any INDEPENDENT MEDICAL EXAMINATION REPORTS for listing last in order of date of treatment.

Summarize Records

1. Summarize the records by noting the important, relevant and highlights of the records and reports; anything significant pre-existing, sustained on the date of loss or subsequent to date of loss

2. Note follow visits or office visit

3. Briefly describe medical treatment for conditions/injuries that are not related to the incident/accident or to the body parts alleged to have been injury

4. Note medication names taken and prescribed in CAPITAL LETTERS

5. Note prior medical history to include any injuries, conditions, diseases

6. Note prior surgical history

7. Note results/impressions of all diagnostic testing

Return Summarization

1. Return summary with page numbers noted and matter number placed thereon

2. Return records in order of provider as set forth on summary to be printed on-shore

3. Return other sheets of paper extracted from digital records provided in a separate transmittal with matter number affixed thereto

Any other essential function that may occur from time to time as directed by the Supervisor.

Skills

Technical Skills (Minimum) * Sound knowledge of clinical medicine

* Good Computer Navigation Skills

* Good keyboarding speed

* Good written and verbal communication, proficiency in English language.

* Interpersonal communication and influencing skills.

* Prioritization and time management skills.

Technical Skills (Desired)

* Good knowledge of complete MS Office Suite

Soft skills (Minimum) * Excellent Communication Skills

* Business awareness

* Customer Service Focus

* Active listening skills

* Good communication skills

Soft Skills (Desired)

* Self disciplined and result oriented

Education Requirements

* Registered Nurse / Doctor (Dentist / Physiotherapist / Homeopathy / Unani / Ayurvedic)

* Science Graduate with medical transcription background of at least 1 year

Work Experience Requirements

* Nurse / Doctor – Minimum one year of hospital experience after internship.

* Medical Transcriptionist – Minimum 1 year of experience from a good institute will be preferred.

Salary:

INR 2,50,000 – 4,00,000 P.A. best in the industry

Industry:

BPO / Call Centre / ITES

Functional Area:

ITES, BPO, KPO, LPO, Customer Service, Operations

Role Category:

Voice

Role:

Associate/Senior Associate -(NonTechnical)

Keyskills:

medical summarization

Education:

UG – BDS – Dentistry, Other Graduate
PG – Any Postgraduate – Any Specialization, Post Graduation Not Required
Doctorate – Any Doctorate – Any Specialization, Doctorate Not Required

Please refer to the Job description above

Company Profile

EXL Services.com ( I ) Pvt. Ltd.
http://www.exlservice.com

EXL (Nasdaq:EXLS) is a leading business process solutions company that helps companies drive business impact and adapt faster to the changing global marketplace. EXL provides operations management, embedded analytics and technology platforms to organizations in the banking and financial services, healthcare, insurance, utilities, transportation and logistics, and travel industries. With more than 21,000 people around the world, we work with our clients as strategic partners to execute operations, identify opportunities to gain a competitive edge, and create new channels for growth and savings. Headquartered in New York and operational since 1999, EXL is present in the U.S., U.K., Singapore, Romania, the Philippines, India, Germany, Czech Republic and Bulgaria.