Executives-Claims Analyst-Repricing and Extended functions

2 days ago


Chennai, Tamil Nadu, India EXL Talent Acquisition Team Full time ₹ 4,00,000 - ₹ 6,00,000 per year

Job description:

  • Review and analyze medical records and claims data to ensure accuracy, completeness, and compliance with healthcare regulations and payer requirements.
  • Verify that all necessary clinical documentation is included to support claim submissions and medical necessity.
  • Identify and resolve inconsistencies, errors, or missing documentation in patient records or claims.
  • Prioritize and manage workloads to ensure expedited and high-priority cases are processed within defined timelines.
  • Collaborate with healthcare providers, coders, and billing staff to obtain or clarify necessary information.
  • Ensure compliance with HIPAA, CMS, and other regulatory guidelines related to medical record handling and claims processing.
  • Prepare accurate reports and summaries of claim findings, trends, and potential process improvements.
  • Support internal audits and quality assurance initiatives by providing detailed documentation and analytical insights.
  • Maintain a strong understanding of healthcare terminology, coding standards (ICD, CPT, HCPCS), and insurance claim procedures.


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