MDI Network
MDI Network
Location Positions Requirements
Pune, India 1
  • 5+ years of experience required
  • Adjudicate claims for benefits offered by government and commercial plans.
  • Work on cases assigned to determine: (1) a person's eligibility for various Social Security or workers' compensation benefits, (2) protection of the environment, (3) the enforcement of health and safety regulations, (4) employment discrimination, and (5) compliance with economic regulatory requirements.
  • Review applicant’s case and examine background.
  • Check all reports and facts thoroughly, including criminal history, immigration and citizen status, and intelligence reports.
  • Prepare analysis recommending specific courses of action.
  • Show justification for recommended course of action.
  • Maintain security clearance.
  • Supervise support personnel.
  • Research and analyze laws, regulations, policies, and precedent decisions to prepare for hearings and to determine conclusions
  • Issue subpoenas.
  • Determine existence and amount of liability according to current laws.
  • Authorize payment of valid claims.
  • Compromise on settlements.
  • Monitor activities of trials and hearings.
  • Explain rulings to claimants and how they may appeal.
  • Prepare written decisions
  • Evaluate claim applications, birth and death certificates, and employer records.

Please send your resume to contact@mdinetworx.com keeping position title as subject

Location Positions Requirements
Pune, India 1
  • 5+ years of experience required
  • Ability to develop scenarios on data analysis, data mapping , data transformation rules using SQL.
  • Hands-on experience of data management and good understanding of US Healthcare EDI i.e. X12 ANSI format of almost all type 837,835,834,270&271,276&277,278,999 etc
  • Work in the analysis phase of the system development cycle and consult with business users on requirement/feature, identify operating procedures, evaluate existing or proposed systems, and prepare specifications/stories which will be used by DEV/QA team
  • Deep domain knowledge on X12 ANSI EDI (US Health Care).

Please send your resume to contact@mdinetworx.com keeping position title as subject

Location Positions Requirements
Glen Burnie 1
  • 5+ years of experience required
  • Adjudicate claims for benefits offered by government and commercial plans.
  • Work on cases assigned to determine: (1) a person's eligibility for various Social Security or workers' compensation benefits, (2) protection of the environment, (3) the enforcement of health and safety regulations, (4) employment discrimination, and (5) compliance with economic regulatory requirements.
  • Review applicant’s case and examine background.
  • Check all reports and facts thoroughly, including criminal history, immigration and citizen status, and intelligence reports.
  • Prepare analysis recommending specific courses of action.
  • Show justification for recommended course of action.
  • Maintain security clearance.
  • Supervise support personnel.
  • Research and analyze laws, regulations, policies, and precedent decisions to prepare for hearings and to determine conclusions
  • Issue subpoenas.
  • Determine existence and amount of liability according to current laws.
  • Authorize payment of valid claims.
  • Compromise on settlements.
  • Monitor activities of trials and hearings.
  • Explain rulings to claimants and how they may appeal.
  • Prepare written decisions.
  • Evaluate claim applications, birth and death certificates, and employer records.

Please send your resume to contact@mdinetworx.com keeping position title as subject

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