US Health Care

2 weeks ago

Navi Mumbai, Maharashtra, India INTEGRUM OUTSOURCE SOLUTIONS PVT LTD Full time ₹ 20,000 - ₹ 25,000 per year

Job Title: Provider Support (Inbound Voice Process)

Department: Operations

Employment Type: Full-Time

Reports To: Team Manager

Company: Integrum Outsource Solutions Private Limited

Work Shift: Night Shift

Eligibility: Only Male Candidates (Boundaries: Thane to Panvel)

Job Summary:

We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process. The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards.

Key Responsibilities:

  • Analyze, review, and adjudicate provider claims.
  • Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials.
  • Ensure compliance with company policies, state and federal regulations, and client guidelines.
  • Review claims to verify cost reasonability and medical necessity.
  • Identify and report overpayments, underpayments, and other discrepancies.
  • Communicate with reinsurance brokers for claim processing information.
  • Verify member eligibility, benefit coverage, and authorization requirements.
  • Utilize domain knowledge to solve problems and improve workflows.
  • Maintain HIPAA compliance and protect confidential claim information.
  • Provide process improvement suggestions and update documentation accordingly.
  • Perform administrative duties as assigned.

Required Qualifications:

Experience & Skills -

  • Freshers with excellent communication skills with interest = in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply.
  • Typing speed of at least 30 WPM.
  • Effective verbal and written communication skills.
  • Active listening and ability to assess customer needs.
  • Critical thinking and problem-solving skills.

Work Environment & Benefits:

  • Work from Office - Seawoods Darave, Navi Mumbai
  • Drop Facility Available
  • Competitive Salary - Rs. 20,000 to Rs. 25,000

Compliance & Adherence:

  • Must comply with all company policies and procedures.
  • Adherence to HIPAA regulations and healthcare compliance standards.

If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team

Job Type: Full-time

Pay: ₹20, ₹25,000.00 per month

Schedule:

  • Night shift

Language:

  • English (Required)

Location:

  • Navi Mumbai, Maharashtra (Required)

Shift availability:

  • Night Shift (Required)

Work Location: In person

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