associate - medical coding.

Description: Locations: IND-HyderabadRole: VMO - Risk AnalystDesired Educational Background, Skills and Experience:• 2-5 years prior experience with risk management across the third-party engagement lifecycle and an understanding of the associated organizational infrastructure (e.g. relevant internal controls, business processes, governance structures) in a regulated (financial, pharmaceutical, health care, etc.) industry is highly desired.• Standard Business Information tools and programming/query languages preferred.• Ability to process/analyze challenges that are not clear yet generate insights and perspectives.• Excellent written and verbal communication skills. Excellent PowerPoint and Excel skills.• Basic knowledge of standards such as ISO 27001/2, ISO 22301, ISO 27018, PCI-DSS, etc.• Basic understanding of the TPRM framework, Risk Management, Information Security practices• Experience in using TPRM tools and technology solutions (e.g., Process Unity)

Mandatory: -• Understanding US healthcare (Commercial, Medicare, Medicaid)• One should have hands on experience with Rx. configuration and review by reading data based on healthcare files.• Responsible for developing and executing complex business data and requirements into benefits creation, analysis, testing and validation.• 2+ years of solid experience writing complex SQLs against various DBMS and RDBMS and help to collate data in excel reports• Position will develop and maintain analytical reporting to support pharmacy programs, UAT, report reconciliation, statistical and clinical (Commercial) analyses.• Develops new and standard reports utilizing data warehouse information using pharmacy-supported platforms.• Hands on work experience in automation scripting software• Handle problems/issues where analysis of situations, or data, requires an evaluation of intangible factors, innovative solutions, and effective and collaborate with leadership• Effective communication skills and ability to exchange thoughts and e-mails with sr. business leaders, Anthem/IngenioRx partners• PBM knowledge will be big plus• Develop and execute benefits data mining analyses using complex programming languages to extract data from existing and new sources• Develop and prepare data analyses and financial models to be shared with others

1 - 3 years experience in medical coding (US Healthcare)• Experience with ICD-10 and CPT coding and its documentation• Review medical records, if necessary, to support the position of anomaly identified within claims data• Sound knowledge of medical terminology and anatomy & physiology• Must be willing to work rotational shifts including US shift• Graduation/certification in life sciences will be added advantage• Proficiency in MS office tools• Excellent written and oral communication skills• Medical Coder certification (CPC or CCS-P or CPC-H or CPC-P) from an accredited source (e.g., American Health Information Management Association, American Academy of Professional Coders) will be highly desirable• Should have the ability to analyze data and draw patterns• Experience in working for Payer end is an added advantage• Ability to pay attention to detail