TL-Claims HC

Job Summary

We are seeking a dedicated professional for the role of TL-Claims HC with 5 to 7 years of experience. The candidate will be responsible for overseeing claims adjudication processes ensuring accuracy and efficiency. This hybrid role requires expertise in MS Office and UiPath with a strong understanding of payer and provider domains. The position involves night shifts offering an opportunity to contribute to our mission of enhancing healthcare services.

Responsibilities

• Oversee the claims adjudication process to ensure accuracy and compliance with industry standards.
• Implement and optimize automation solutions using UiPath to streamline claims processing.
• Collaborate with cross-functional teams to enhance the efficiency of claims management.
• Analyze claims data to identify trends and areas for improvement in the adjudication process.
• Provide training and support to team members on best practices in claims adjudication.
• Develop and maintain documentation for claims processing procedures and automation workflows.
• Ensure adherence to payer and provider guidelines to maintain compliance and quality standards.
• Utilize MS Office tools to generate reports and presentations for management review.
• Monitor and evaluate the performance of claims processing systems to identify potential enhancements.
• Coordinate with IT teams to resolve technical issues related to claims processing systems.
• Engage with stakeholders to gather feedback and implement process improvements.
• Support the development of strategies to reduce claim processing times and improve customer satisfaction.
• Maintain up-to-date knowledge of industry regulations and trends to ensure compliance.

Qualifications

• Demonstrate proficiency in MS Office applications for data analysis and reporting.
• Exhibit expertise in UiPath for developing and managing automation solutions.
• Possess in-depth knowledge of claims adjudication processes and best practices.
• Showcase experience in the payer and provider domains to ensure effective claims management.
• Display strong analytical skills to identify and address process inefficiencies.
• Communicate effectively with team members and stakeholders to drive process improvements.