Medical Claims Professional

2 days ago


tiruppur, India beBeeClaims Full time

Job Title: Health Claims SpecialistThe company is seeking a detail-oriented and experienced Health Claims Specialist to process and adjudicate medical claims accurately in accordance with industry regulations and contractual agreements.Reviewing and analyzing medical claims submitted by healthcare providers for accuracy, completeness, and compliance with insurance policies and regulatory requirementsVerifying patient eligibility, insurance coverage, and benefits to determine claim validity and appropriate reimbursementAssigning appropriate medical codes (e.g., ICD-10, CPT) to diagnoses, procedures, and services according to industry standards and guidelinesAdjudicating claims based on established criteria, ensuring fair and accurate reimbursementProcessing claims promptly and accurately using designated platforms, investigating and resolving discrepancies, coding errors, and claims denials through effective communication with healthcare providers, insurers, and internal teamsRequirements:A Bachelor's degree in a related field or a minimum of 1-2 years of experience in healthcare claims processing, medical billing, or health insurance administration.Key Responsibilities:The successful candidate will possess excellent analytical and problem-solving skills, with the ability to work accurately under pressure and maintain confidentiality when handling sensitive information. They must also be proficient in relevant software applications and have strong communication and interpersonal skills.



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