Healthcare and Insurance Operations Analyst
2 days ago
HC and Insurance Operations Analyst
Role Responsibilities:
- In-depth knowledge and experience in the US healthcare (Non Voice) – Provider Data Validation and Provider Data management.
- Candidate should have 3 years and above experience in US healthcare and into provider enrollment and credentialling.
- Ensures day-day transactions are processed per standard operating procedures.
- Follows Work process flow to ensure pends are completed and maintain Quality and timeliness standards.
- Knowledge in Amisys and Cenprov application are preferred.
- Product knowledge in checking affiliation for Medicaid, Medicare and Exchange.
- Everyday checked Contract information in Payment Index such as, Pay class, override key, accepts code and etc.
- Ability to read and understand the provider contract.
- Handling Paid claims and recouped claims.
- Claims Rejections handling.
- Working in claims denial management.
- Knowledge about End to End provider billing process.
- Working knowledge in EDI rejection claims
- Handing Patient and provider demographic changes.
Required Skills:
- 3 to 5 years of experience in US healthcare working with Provider Data Enrollment and Management.
- Ability to work in a 24/5 environment; shifts can be rotational.
- University degree or equivalent that required 3+ years of formal studies.
- Ability to work in a team environment.
- Good logical thinking ability.
- Good English Comprehension/written skills should have exposure to MS Office.
- Good Communication Skills – Both Verbal and Written
- Ability to interact with clients preferred.
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