Healthcare Claims Examiner
7 days ago
Job Description: As a Healthcare Claims Examiner at Mphasis, you will play a vital role in ensuring the accuracy and efficiency of healthcare claims processing.
Key Responsibilities:
- Review and process medical claims according to established guidelines and turnaround time frames.
- Adjudicate claims by approving or denying them according to established guidelines.
- Conduct investigations of pended claims and follow up with respective departments to finalize claims resolution.
- Maintain accurate records and notes of claims-related documentation.
- Ensure adherence to all quality parameters and schedule.
Essential Skills:
- Minimum one year of experience in examining and processing healthcare claims.
- Medical claims processing experience is a must.
- Provider Maintenance, Enrollment experience required.
- Proficiency with computers.
- Typing speed of 35 to 40 wpm with 95% accuracy.
Education: Undergraduate (10+2)/Diploma / Graduate (Only Arts or Science) - Non-Technical Only.
Working at Mphasis: As a key member of our team, you will be responsible for ensuring the highest level of customer satisfaction while maintaining a very high level of quality standards.
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