Trainee Associate

2 weeks ago

Remote, India CHCS Services Full time ₹ 4,00,000 - ₹ 12,00,000 per year

Ability to review and analyze complex medical documentation with a high degree of accuracy to prevent errors in claims processing and familiarity with medical coding systems (CPT, ICD, HCPCS) to understand and interpret medical procedures and diagnoses.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following.

o Ability to review and analyze complex medical documentation with a high degree of accuracy to prevent errors in claims processing.

o Evaluate claims against established guidelines, contracts, and regulatory requirements.

o Conduct detailed research on complex claims, pre-existing conditions, and other intricate scenarios.

o Analyze medical records, policy documents, and other relevant information to make informed claim decisions.

o Demonstrate proficiency in healthcare coding systems (e.g., CPT, ICD-10, HCPCS, Revenue codes, medical terminologies, Human Anatomy, Inpatient Vs. Outpatient claims) to accurately assess claims.

o Apply knowledge of healthcare benefits and payment policies.

o Provide clear and concise explanations of claim decisions to relevant parties.

o Identify trends and patterns in complex claims to contribute to process improvements.

o Candidate should be able to correctly calculate claim amounts for the customers.

o Complying with company regulations regarding HIPAA, confidentiality, and private health information.

Job Type: Full-time

Benefits:

  • Health insurance
  • Provident Fund
  • Work from home

Work Location: Remote

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