Claim Adjudicator

**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...

Role BPO Health Claims Adjudication Associate Experience Range 1 to 3 year Location DLF - Chennai Work From Office Shift Timing - US Central time 6 00 PM to 4 00 AM IST Transport - Only DROP Notice Period Immediate - 15 days for BPO Health Claims Adjudication Associate Roles and Responsibilities Required computer skills must have experience with data entry...

-Application development experience in Design, coding, testing and debugging with mainframe skills such as CICS, VSAM, COBOL, DB2, JCL, Zeke, File Aid, Changeman, AbendAid-Programming, conduct code reviews, and test software as needed, ensuring quality of deliverables-Should have experience in Claim adjudication experienceNote: Applicants should be ready to...

-Application development experience in Design, coding, testing and debugging with mainframe skills such as CICS, VSAM, COBOL, DB2, JCL, Zeke, File Aid, Changeman, AbendAid -Programming, conduct code reviews, and test software as needed, ensuring quality of deliverables -Should have experience in Claim adjudication experience Note: Applicants should be ready...

Process all claims in each Level 1, 2 within 3 business day and maintain the turnaround time with in the specified global target - Discussed with market on age claims on weekly basis and take appropriate actions on the claims" - Claim Assessing based on Policy and provide suggestion to be implemented in policy - Do Claim Adjudication feedback analysis and...

Process all claims in each Level 1, 2 within 3 business day and maintain the turnaround time with in the specified global target - Discussed with market on age claims on weekly basis and take appropriate actions on the claims" - Claim Assessing based on Policy and provide suggestion to be implemented in policy - Do Claim Adjudication feedback analysis and...

**Position: HC & Insurance Operations Associate** **Location: Chennai/Coimbatore** **Experience: 1 to 3 years** **Notice period: Immediate joiners** **Roles and Responsibilities**: -      Process Adjudication claims and resolve for payment and Denials -      Knowledge in handling authorization, COB, duplicate, pricing and corrected...

**Adjudication - Claim Examiner "Fresher or Experience"** - Responsible for the coordination and resolution of the administrative denials and appeals. - Ability to understand logic of standard medical coding (i.e., CPT, ICD-10, HCPCS, etc.). - Ability to resolve claims that require adjustments and adjustment projects, Identify claim(s) with inaccurate data...

Job Titile: Claims Examiner IDo you see…? Are you passionate about …?  About us:  For over 20 years, Smart Data Solutions has been partnering with leading payer organizations to provide automation and technology solutions enabling data standardization and workflow automation. The company brings a comprehensive set of turn-key services to handle all...

Roles and Responsibilities 2-3 years of experience in processing claims adjudication and adjustment process Experience in professional HCFA and institutional UB claims Knowledge in handling authorization COB duplicate and pricing process Knowledge of healthcare insurance policy concepts including in network out of network providers deductible coinsurance...