Senior Medical Claims Examiner

5 days ago

mount, India beBeeMedical Full time

Health Claims Specialist Job OverviewThe position of Health Claims Specialist involves accurately processing and adjudicating medical claims in accordance with industry regulations, contractual agreements, and company policies.This role requires a detail-oriented individual who can review and analyze medical claims for accuracy, completeness, and compliance with insurance policies and regulatory requirements. The successful candidate will also be responsible for verifying patient eligibility, insurance coverage, and benefits to determine claim validity and appropriate reimbursement.Key Responsibilities:Reviewing and analyzing medical claims submitted by healthcare providersVerifying patient eligibility, insurance coverage, and benefitsDetermining claim validity and appropriate reimbursementAdditionally, the ideal candidate will have proficiency in medical coding systems (e.g., ICD-10, CPT) and claims processing software platforms. A Bachelor's degree in a related field, such as B.A.M.S, B.U.M.S, B.H.M.S,, B.D.S, BSMS,,BPT or a related field preferred. A minimum of 1-2 years of experience in healthcare claims processing, medical billing, or health insurance administration is required.Responsibilities may include but are not limited to:Assigning appropriate medical codes (e.g., ICD-10, CPT) to diagnoses, procedures, and services according to industry standards and guidelinesProviding exceptional customer service to internal and external stakeholdersRequired Skills and Qualifications:Bachelor's degree in a related field (e.g., B.A.M.S, B.U.M.S, B.H.M.S, B.D.S, BSMS, BPT)Minimum 1-2 years of experience in healthcare claims processing, medical billing, or health insurance administrationProficiency in medical coding systems (e.g., ICD-10, CPT)Claims processing software platform expertiseBenefits:Competitive salary and benefits packageOpportunities for career advancement and professional growthHow to Apply:

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