Insurance Claims Operations Specialist

4 days ago


Coimbatore, Tamil Nadu, India beBeeOperations Full time ₹ 8,00,000 - ₹ 10,00,000
Claims and Denials Resolution Specialist

Process adjudication claims and resolve for payment and denials in a timely and accurate manner.

This role requires strong analytical skills, excellent communication skills, and the ability to work independently.

Key Responsibilities:

  • Process adjudication claims and resolve for payment and denials
  • Knowledge of healthcare insurance policy concepts, including in-network and out-of-network providers, deductibles, coinsurance, co-pay, and maximum inside limits and exclusions
  • Ensure accurate and timely completion of transactions to meet or exceed client service level agreements (SLAs)
  • Organize and complete tasks according to assigned priorities
  • Develop and maintain a solid working knowledge of the healthcare insurance industry and all products, services, and processes performed by the team

Requirements:

  • 1-3 years of experience in processing claims, adjudication, and adjustment process
  • Experience with Facets is an added advantage
  • Experience in professional, HCFA, institutional, UB claims optional
  • Good communication and strong reading comprehension and writing skills
  • Able to work independently with strong analytic skills

Work Schedule:

The required schedule availability for this position is Monday-Friday, 5:30 PM - 3:30 AM IST, AR Shift. The shift timings can be changed as per business requirements. Additionally, resources may have to do overtime and work on weekend basis as per business needs.



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