Only 24h Left Knowledge Specialist

6 hours ago

Pune Maharashtra, India Mphasis. Full time

Job title Knowledge Specialist Band 5 Level 2 Reports to Unit Manager Asst Unit ManagerProvides customer service support for third party administrators Health Maintenance organizations preferred provider organizations managed care organizations and many more in US healthcare insurance market by identifying and updating information The ultimate motive is to ensure commendable service standards and maintain very high customer satisfaction Technical Skills Minimum 1 - 2 years experience in examining and processing Healthcare claims required Medical claims processing experience is a must Provider Maintenance Enrollment experience required Proficiency with computers Process Skills Listed below are the primary job duties and responsibilities that are required Review claims for legitimacy and accuracy Adjudicate claims by approving or denying them according to established guidelines Conducts investigation of pended claims and follow up with respective departments to finalize claims resolution Staying current with knowledge of products processes services offered by the client Review and process medical claims according to guidelines within established turnaround time frames Maintain accurate records notes of claims related documentation Ensure full adherence to all the quality parameters Ensure 100 adherence to schedule Meeting all defined targets like Productivity quality Maintenance of required reports in Excel Behavioral Skills Look up for relevant information and update type into the client systems as per set procedures and policies Attention to detail while accomplishing tasks meeting Weekly Daily targets with required quality in the given timelines Enter updates relating to pertinent healthcare data into the computer system in a timely manner ensuring accuracy completeness and adherence to department procedures Review data for deficiencies or errors correct any incompatibilities if possible Adhere to the team norms for making the overall team a cohesive one Ability to prioritize and manage workload Must be ready to work in night shifts Certification Undergraduate 10 2 Diploma Graduate Only Arts or Science Non-Technical Only Typing speed 35 to 40 wpm with 95 accuracy without looking at the keyboard Good communication skills Skills PRIMARY COMPETENCY Healthcare PRIMARY SKILL Healthcare-Claims Adjudication PRIMARY SKILL PERCENTAGE 100About Company Mphasis is a leading IT solutions provider offering Applications Business Process Outsourcing BPO and Infrastructure services globally through a combination of technology knowhow domain and process expertise The accolades we have been garnering can be attributed to our undeterred focus in delivering quality solutions across verticals that meet the challenging requirements of our esteemed customers We have been recently felicitated by the economic times as the most distinguished digital company 2015 We have also been ranked 29 of 100 largest financial technology vendors by American Banker and BAI in the FinTech Forward Top 100 rankings

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