Claims Examiner with Insurance Industry Expertise

4 days ago


Chennai, Tamil Nadu, India Synthesis Healthcare Services LLP Full time
Job Overview

We are seeking a highly skilled Claims Examiner to join our team at Synthesis Healthsoft Services & Solutions LLP. This role is ideal for individuals with experience in HCFA/UB claim processing and a strong understanding of CMS processing guidelines.

About the Role

The successful candidate will be responsible for coordinating and resolving administrative denials and appeals, as well as analyzing claims data to identify areas for improvement. A strong analytical mindset and excellent communication skills are essential for this position.

Responsibilities
  • Review and resolve claims requiring adjustments and adjustment projects.
  • Identify claims with inaccurate data or those requiring review by team members.
  • Meet and exceed production, productivity, and quality goals.
  • Process insurance claims timely and qualitatively.
  • Apply trained client-level business rules to make appropriate claims decisions, flag potential issues, and ensure compliance with industry standards.
Requirements
  • Bachelor's degree or higher in a related field (e.g., healthcare administration, finance).
  • 1-5 years of experience in HCFA/UB claim processing.
  • Strong knowledge of CMS processing guidelines.
  • Excellent analytical and communication skills.
  • Working proficiency in MS Office tools.
  • Ability to work flexible shifts, including evenings and weekends (day shift only).
Salary Information

The estimated salary range for this role is ₹6-8 lakhs per annum, depending on qualifications and experience. We offer a competitive compensation package that includes benefits and opportunities for professional growth.

Location

This role is based in OMR, Kottivakkam, Chennai, with occasional travel required for training and meetings.

Contact Us

For more information about this opportunity, please contact us at +91 97897810526 or +91 9176332863.



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