Claims Adjudication

4 days ago

Bengaluru, India CIEL HR Services Full time

Role :Claims Adjudication

Experience :2+years

Location :Coimbatore, Chennai

Skills
- Claim process, Medical Coding

Shift :US shifts

Claims Experience In This 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 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 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

**Contact

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