Senior Insurance Claims Specialist

3 days ago

Coimbatore, Tamil Nadu, India beBeeinsurance Full time US$ 32,000 - US$ 50,900

We are seeking a highly skilled Insurance Claims Specialist to join our team. The ideal candidate will have exceptional analytical and problem-solving skills, with the ability to work in a fast-paced environment.

Job Summary:

The Insurance Claims Specialist will be responsible for reviewing and processing insurance claims in accordance with defined policy and procedure. This includes validating member, provider, and other claims information, determining accurate payment criteria, and coordinating claim benefits based on policy and procedure.

Key Responsibilities:
  • Claims Review: Review and process insurance claims in accordance with defined policy and procedure
  • Information Validation: Validate member, provider, and other claims information
  • Payment Criteria Determination: Determine accurate payment criteria for clearing pending claims
  • Claim Benefits Coordination: Coordinate claim benefits based on policy and procedure
  • Productivity and Quality: Maintain productivity goals, quality standards, and aging timeframes
  • Document Scrutiny: Scrutinize medical claim documents and settlements
  • Task Management: Organize and complete tasks per assigned priorities
Requirements:
  • Educational Background: University degree or equivalent with formal studies of the English language and basic math
  • Experience: 0-1 year of experience applying business rules to varying fact situations and making appropriate decisions
  • Data Entry Experience: 0-1 year of data entry experience requiring quality, attention to detail, accuracy, and accountability
  • Computer Skills: 0-1 year of experience using a computer with Windows PC applications and software tools
  • Workload Prioritization: 0-1 year of experience prioritizing workload to meet deadlines
About Our Organization:

We are a global innovator of business and technology services, serving 75% of the Fortune Global 100. We are committed to helping clients innovate, optimize, and transform for long-term success.

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