Claims Handler

**Role**: HC & Insurance Operations Associate

**Shift Timings**: 6 PM-4 AM IST (AR SHIFT)

**Location**: Chennai/Coimbatore (Currently Remote)

**Double vaccination required**

**Roles and Responsibilities**:

- Process Adjudication claims and resolve for payment and Denials
- Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
- Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations
- Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
- Organizing and completing tasks according to 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**:

- 1-3 years of experience in processing claims adjudication and adjustment process
- Experience in professional (HCFA), institutional (UB) claims (optional)
- Both under graduates and post graduates can apply
- Good communication (Demonstrate strong reading comprehension and writing skills)
- Able to work independently, strong analytic skills
- Experience into Authentication & pre - authentication
- Experience in Member eligibility criteria

Pay: ₹100,000.00 - ₹320,000.00 per year

**Benefits**:

- Health insurance
- Internet reimbursement
- Work from home

Schedule:

- Monday to Friday
- Night shift
- US shift

Supplemental pay types:

- Shift allowance

Ability to commute/relocate:

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

**Experience**:

- total work: 1 year (preferred)