Claim Adjudicator

2 weeks ago


Chennai, India TekWisen Software Pvt. Ltd Full time

Experience: 1-3 Years

Notice Period: Immediate - 15 Days Joiners

Location: Chennai,Coimbatore

**Skills**:

- 1-3 years of experience in processing claims adjudication and adjustment process
- Experience of Facets is an added advantage.
- Experience in professional (HCFA), institutional (UB) claims (optional)
- Both under graduates and post graduates can apply
- Good communication (Demonstrate strong reading comprehension and writing skills)
- Able to work independently, strong analytic skill

**Roles and Responsibilities**:

- Process Adjudication claims and resolve for payment and Denials
- Knowledge in handling authorization, COB, duplicate, pricing and 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

**Salary**: ₹177,268.79 - ₹274,629.26 per year

**Benefits**:

- Health insurance
- Provident Fund

Schedule:

- Flexible shift
- Night shift
- Rotational shift

**Experience**:

- total: 2 years (required)


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