Bpo Hc

In these roles you will be responsible for:

- Review and process insurance claims.
- Validate Member, Provider and other Claim’s information.
- Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
- Coordination of Claim Benefits based on the Policy & Procedure.
- Maintain productivity goals, quality standards and aging timeframes.
- Scrutinizing Medical Claim Documents and settlements.
- Organizing and completing tasks per 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 for this role include:

- University degree or equivalent that required formal studies of the English language and basic Math
- 2+years of adjudication experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
- 6+ months of experience that required prioritizing your workload to meet deadlines

Preferences: - Optional (nice-to-have’s)
- Ability to communicate (oral/written) effectively to exchange information with our client.

Required schedule availability for this position is Monday-Friday (06:00pm to 04:00am IST). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend’s basis business requirement.