▷ High Salary: Claims Auditor

3 weeks ago


Chennai, India EXL Full time
About the Role - Looking for Claims Auditor in Healthcare - Min 3 Years of experience.

Responsibilities -

- Specifically in Claims adjudication, claims processing, pricing, administrative records review experience pertinent to US Healthcare PAYOR domain- Medical Records Management, Clinical Audit based on Medical Records Review, Seasoned experience in US Healthcare (Payer/Provider LOB)- Preferred to have worked over a period of time in US Healthcare payer/provider domain- Understand the business model for our delivery center and then implement the same in the training vertical- Should have effective communication skills to coordinate with program SMEs and candidates- Should be well accustomed with reporting, presentations, creating training materials (videos/document) in granular level- Should possess understanding of High Cost Drug and Durable Medical equipment auditing through Medical records review- Previously working for US Healthcare Payer vertical/LOB will be an added advantage- Follow every aspect of SOP without fail- Complete received Audits with Quality- To meet the team/Client Quality and 100% of production target on a daily basis- Follow project related protocols and instructions- Escalate issues, identify trends...- Update all the logs like productivity, Clarification log, and any other logs applicable on a daily basis- Should be read to extend support working on weekends a and when applicable- Should be a good team member to ensure the smooth service delivery- Should be a good and fast learner- All emails from Leads, Team members, Manager and higher hierarchy should be answered promptly without fail- Ensure Healthcare compliance of entire team for HIPAA, OIG, PHI etc.

Qualifications - Graduation is mandatory (bachelor's degree)

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