Us Healthcare, Claim Adjudiation

1 week ago


Chennai, India TekWisen Software Pvt. Ltd Full time

**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 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 of Facets is an added advantage.
-      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

**Benefits**:

- Flexible schedule
- Health insurance
- Life insurance
- Paid time off
- Work from home

Schedule:

- Night shift

Supplemental pay types:

- Overtime pay
- Performance bonus

Ability to commute/relocate:

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

**Experience**:

- total work: 2 years (required)
- Health insurance


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