
Hiring For Claims Adjudication
1 day ago
Roles and Responsibilities:
- Process Adjudication claims and resolve for payment and Denials
- Knowledge in handling authorization, COB, duplicate, pricing, and the corrected claims process
- Knowledge of healthcare insurance policy concepts, including in-network, out-of-network providers, deductible, coinsurance, co-pay, out-of-pocket, maximum inside limits, and exclusions, state variations
- Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
- Organizing and completing tasks according to assigned priorities.
- Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services, and processes performed by the team
- Resolving complex situations following pre-established guidelines
Requirements:
- 1-3 years of experience in processing claims, adjudication, and the adjustment process
- Experience of Facets is an added advantage.
- Experience in professional (HCFA), institutional (UB) claims (optional)
- Both undergraduates and postgraduates can apply
- Good communication (Demonstrate strong reading comprehension and writing skills)
- Able to work independently, strong analytical skills
**Required schedule availability for this position is Monday-Friday 5.30 PM/3.30 AM IST (AR SHIFT). The shift timings can be changed as per client requirements. Additionally, resources may have to work overtime and on a weekend basis to meet business requirements.
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