Claims Adjudicator

4 days ago

Chennai, India CIEL HR Services Full time

**Role you will be Responsible For**
- Experienced level adjudicator providing analytical ability to review claim rules and workflows.
- Reviews claim requests to determine eligibility for processing and escalate to management as necessary.
- Responsible for the coordination and resolution of the administrative denials and appeals
- Ability to resolve claims that require adjustments and adjustment projects, Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
- Organizing and completing tasks per assigned priorities.
- Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
- Resolving complex situations following pre-established guidelines

**Requirements for this role include**:

- University degree or equivalent that required formal studies of the English language and basic Math
- 1+ year(s) of experience processing claims for the US healthcare market

Work from Office Job

Shift timings - US shift - 7 pm - 4 am

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