Healthcare Operations Specialist

3 days ago


Coimbatore, Tamil Nadu, India beBeeInsurance Full time ₹ 7,26,800 - ₹ 14,79,600

Our company is seeking a highly skilled professional to fill the role of Senior Representative in Health Care and Insurance Operations.

Job Description

We are currently looking for an individual who will be responsible for reviewing and processing insurance claims, validating member, provider and other claims information, determining accurate payment criteria for clearing pending claims based on defined policy and procedure, coordinating claim benefits based on the policy & procedure, maintaining 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.

Required Skills and Qualifications
  • University degree or equivalent that required formal studies of the English language and basic Math.
  • 0-1 Year of experience where you had to apply business rules to varying fact situations and make appropriate decisions.
  • 0-1 Year of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
  • 0-1 Year of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
  • 0-1 Year of experience that required prioritizing your workload to meet deadlines.
Benefits

Our company offers a variety of benefits including flexible scheduling, opportunities for growth and development, and a collaborative work environment.

Other Information

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.



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