Us Health Care

3 days ago

Navi Mumbai Maharashtra, India INTEGRUM OUTSOURCE SOLUTIONS PVT LTD Full time

**Job Title**: Provider Support (Inbound Voice Process)

**Department**: Operations

**Employment Type**: Full-Time

**Reports To**: Team Manager

**Company**: Integrum Outsource Solutions Private Limited

**Work Shift**: Night Shift

**Job Summary**:
We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our **Inbound Voice Process**. The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards.

**Key Responsibilities**:

- Analyze, review, and adjudicate provider claims.
- Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials.
- Ensure compliance with company policies, state and federal regulations, and client guidelines.
- Review claims to verify cost reasonability and medical necessity.
- Identify and report overpayments, underpayments, and other discrepancies.
- Communicate with reinsurance brokers for claim processing information.
- Verify member eligibility, benefit coverage, and authorization requirements.
- Utilize domain knowledge to solve problems and improve workflows.
- Maintain HIPAA compliance and protect confidential claim information.
- Provide process improvement suggestions and update documentation accordingly.
- Perform administrative duties as assigned.

**Required Qualifications**:
**Experience & Skills -**
- Freshers with excellent communication skills with interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply.
- Typing speed of at least 30 WPM.
- Effective verbal and written communication skills.
- Active listening and ability to assess customer needs.
- Critical thinking and problem-solving skills.

**Work Environment & Benefits**:

- **Work from Office** - Seawoods Darave, Navi Mumbai
- **Drop Facility Available**:

- **Competitive Salary -**Rs. 20,000 to Rs. 40,000

**Compliance & Adherence**:

- Must comply with all company policies and procedures.
- Adherence to HIPAA regulations and healthcare compliance standards.

Pay: ₹20,000.00 - ₹40,000.00 per month

**Language**:

- English (preferred)

**Location**:

- Navi Mumbai, Maharashtra (preferred)

Shift availability:

- Night Shift (required)

Work Location: In person

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