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Knowledge Specialist

1 month ago

Pune, Maharashtra, India Mphasis Full time

Company Overview:

Mphasis is a leading digital transformation company that helps businesses navigate the complexities of an ever-changing landscape.

Salary: $55,000 - $65,000 per annum

Job Description:

We are seeking an experienced Claims Resolution Expert to join our team in Mphasis. As a Claims Resolution Expert, you will play a critical role in ensuring timely and accurate resolution of healthcare claims.

The ideal candidate will have a strong background in medical claims processing and excellent analytical skills. You will be responsible for reviewing claims for legitimacy and accuracy, adjudicating claims according to established guidelines, and conducting investigations of pended claims.

You will work closely with cross-functional teams to ensure seamless claim resolution and maintain accurate records of claims-related documentation.

Required Skills and Qualifications:

  • Minimum one year experience in examining and processing healthcare claims required
  • Medical claims processing experience is a must
  • Provider Maintenance, Enrollment experience required
  • Proficiency with computers
  • Typing speed 35 to 40 wpm with 95% accuracy (without looking at the keyboard)
  • Good communication skills

Benefits:

We offer a comprehensive benefits package, including competitive salary, health insurance, retirement plan, and paid time off.

Others:

This role requires working night shifts and meeting all defined targets like productivity, quality, and maintenance of required reports in Excel.