Claims Specialist
2 days ago
Essential Functions- Reviewing and adjudicating medical claims for payment, determining coverage and appropriate coding and verifying information for accuracy.- Evaluate and process claims in accordance with company policies and procedures, as well as to productivity and quality standards.- Interprets and processes routine and claims including CMS 1500 and UB04.- Reviews and analyzes Physician/Hospital contract for correct payment method in-process claims in order to identify and resolve errors prior to final adjudication.- Analyzing historical claims for patient and provider for correct adjudication.- Possess good Knowledge of medical terminology, coding and claims processing.- Consistently maintains production and quality standards based on quality control expectations.- Adaptability in cross training and multiple tasking.- Assists claimants, providers, and clients with problems or questions regarding their claims and/or policies.- Analyzing patient information in order to ensure payment accuracy.- Prepares and prints drafts for payment of claims, refund requests and verifies that payments have been made.- Consistently maintains production and quality standards based on quality control expectations.Primary Internal Interactions- Actively participate in the team meetings, discussions and provide inputs- Calibrate, Cooperate and support the team in pursuit of achieving and exceeding team goalsPrimary External Interactions- Email Communication- Verbal communication during Trainings or ON Query CallsSkillsTechnical Skills- Working knowledge of MS office (Word, Excel and Power point) and Internet / OutlookProcess Specific Skills- Minimum experience of 1 to 3 years in US Healthcare claims processing/adjudication or medical billing with good performance records.Soft skills (Desired)- Good communication skills, both verbal and written- Aptitude and keen eye for details
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Claims Specialist
7 hours ago
Kochi, India EXL Full timeEssential FunctionsReviewing and adjudicating medical claims for payment, determining coverage and appropriate coding and verifying information for accuracy.Evaluate and process claims in accordance with company policies and procedures, as well as to productivity and quality standards.Interprets and processes routine and claims including CMS 1500 and...
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Claims Specialist
2 days ago
Kochi, India EXL Full timeEssential FunctionsReviewing and adjudicating medical claims for payment, determining coverage and appropriate coding and verifying information for accuracy.Evaluate and process claims in accordance with company policies and procedures, as well as to productivity and quality standards.Interprets and processes routine and claims including CMS 1500 and...
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Claims Specialist
2 days ago
kochi, India EXL Full timeEssential FunctionsReviewing and adjudicating medical claims for payment, determining coverage and appropriate coding and verifying information for accuracy.Evaluate and process claims in accordance with company policies and procedures, as well as to productivity and quality standards.Interprets and processes routine and claims including CMS 1500 and...
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Claims Specialist
15 hours ago
Kochi, India EXL Full timeEssential FunctionsReviewing and adjudicating medical claims for payment, determining coverage and appropriate coding and verifying information for accuracy.Evaluate and process claims in accordance with company policies and procedures, as well as to productivity and quality standards.Interprets and processes routine and claims including CMS 1500 and...
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Claims Specialist
2 days ago
Kochi, India EXL Full timeEssential Functions Reviewing and adjudicating medical claims for payment, determining coverage and appropriate coding and verifying information for accuracy. Evaluate and process claims in accordance with company policies and procedures, as well as to productivity and quality standards. Interprets and processes routine and claims including CMS 1500 and...
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Claims Specialist
2 days ago
Kochi, India EXL Full timeEssential FunctionsReviewing and adjudicating medical claims for
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Claims Specialist
23 hours ago
Kochi, India EXL Full timeEssential Functions- Reviewing and adjudicating medical claims for
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Claims Specialist
23 hours ago
Kochi, India EXL Full timeEssential Functions Reviewing and adjudicating medical claims for
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Claims Specialist
2 days ago
Kochi, India EXL Full timeEssential Functions - Reviewing and adjudicating medical claims for payment, determining coverage and appropriate coding and verifying information for accuracy. - Evaluate and process claims in accordance with company policies and procedures, as well as to productivity and quality standards. - Interprets and processes routine and claims including CMS 1500...
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Business Analyst
2 weeks ago
Bengaluru, Kochi, Pune, India Talent Sketchers Full time ₹ 9,00,000 - ₹ 12,00,000 per yearHello Candidates Greetings from Talent SketchersKindly find the details belowDesignation - Business AnalystExperience - 7+ yearsLocation - Pune, Chennai, Mumbai, Bengaluru, Hyderabad, Kochi, ThiruvanthaapuramWork Mode - HybridDetailed JDWe are seeking a highly skilled and detail-oriented BA with specialist RCM knowledge to help in detailing requirements for...
