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Claim Adjudication

2 weeks ago

Chennai, India Synthesis Healthsoft Services & solutions llp Full time

**Claim Examiner - Adjudication**

**JOB SUMMARY**:

- Life Claims: - Processing Death Claims and identifying the right beneficiary(s) to provide the Claims benefit - Setting up a claim and then following up for pending requirements (if any)
- Examining the received documents, payment calculation and settlement - Perform additional review before cutting the check
- Health Claims: - Supporting different set of Health Claims products which includes Wellness, Critical Illness, Accident, Cancer, HI etc.
- Check the eligibility of the member’s product wise that will undergo different set of medical examination proceeding with additional care/treatment
- To perform adjudication which will cover the additional review of the medical history proceeding with medical benefits
- Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
- Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team.

**DESIRED CANDIDATE PROFILE**:

- Any graduate.
- Good Analytical skills.
- Good communication skills.
- Working knowledge of MS office tools.
- Willing to work in any shift.

**Experienced**

** ** Any graduate.
- Having 1-5 years experience in HCFA/UB claim processing.
- Having good exposure to CMS processing guidelines.
- Good Analytical skills.
- Good communication skills.
- Working knowledge of MS office tools.
- Willing to work in any shift.

**EDUCATION QUALICATIFICATION**:

- Any degree

**SHIFTS**:

- Day Shift

**JOB LOCATION**:Chennai

VENUE:
SYNTHESIS HEALTHSOFT

PRAKASH TOWERS, 2ND FLOOR, OMR ROAD KOTTIVAKKAM,

CHENNAI- 600041.

CONTACT:
+91-XXXXXXXXXX

**Salary**: ₹13,500.00 - ₹20,500.00 per month

**Benefits**:

- Health insurance
- Paid sick time
- Paid time off
- Provident Fund

Schedule:

- Day shift

Supplemental pay types:

- Overtime pay
- Performance bonus

COVID-19 considerations:
ALL PRECAUTIONS HAVE TAKEN

Ability to commute/relocate:

- Kottivakkam, Chennai - 600041, Tamil Nadu: Reliably commute or planning to relocate before starting work (required)

**Experience**:

- Claim Examiner: 3 years (preferred)

**Speak with the employer**
+91 9840960091