Claim Processor
- Hinduja Global .
- 1 to 4 Yrs
- Bengaluru
- 7 years ago
- Email to a friend
- Report this job
Job Description
Hello Candidates,
We are hiring for "Medical Billing profiles" below is the detailed JD.
Experience:1+yrs
Qualification:Graduates
Location: Bangalore
Position: Claim Processor(Medical Billing)
Job Description:
Competencies
Key Parameters
Think Strategic
(a) Big Picture Perspective:
- Understand the basic professional standards and established procedures, policies before taking action and making decisions
(b) Business Acumen:
- Processing claim as per the process guidelines
- Is aware of metric applicable to the role
- Adhering to the SLA, and understanding Quality & Auditing parameters
Drive Results
(a) Planning & Organizing:
Understanding and adhering to quality standards
(b) Directing & Monitoring
Acquiring knowledge & skills of related areas of the process
(c) Accountability
Assumes responsibility for work activities and coordinating efforts
Clearly sets a goal and works towards achieving it
(d) Problem Solving & Decision making
an Identify simple problems /issues and tries to improve this based on basic knowledge of the issue
- Identifies problem and escalates it accordingly.
Partner with Customers
(a) Relationship Building
Presents appropriate information in a clear and concise manner, both orally and in writing
Is open to new ideas
(b) Passion for excellence
Understands the Values and Characteristics of work
Lead People
(a) Managing Self
- Adhere to attendance and punctuality norms
- Pursues learning opportunities and ongoing development
- Understands and follows ethical guidelines at ones work place
(b) Inspiring Others / Managing Teams
- Interpersonal relationship at work with peers, supervisors and should not have any recorded instance of misconduct.
Desired skill sets
Technical Skill Set:
Basics Knowledge of United States Health Insurance
o Who Participates in US Healthcare Ex: Patient, Provider, Payer, Supplier etc.
o How does it work Ex: Life cycle of a Claim
Identifying different types of Health Insurance Forms
o Ex: Medical, Hospital, Pharmacy Forms etc.
o Standard Form types (CMS 1500 and CMS1400)
Identifying different types of treatments/services
Ex: Provider Care, Hospital, Inpatient, Outpatient, Emergency, Home health care etc.
Knowledge of Codes
Ex: CPT codes, Revenue codes, Diagnosis Codes, Modifiers, TAX Id, NPI Numbers etc.
- The correct use of billing codes and detection of improper use of billing codes based on Center for Medicare and Medicaid instructions
- Knowledge on Fraud and Ethical issues
- Medical Terminologies
Desired Skill Set:
US Health Insurance (Healthcare Insurance, Workers Compensation)
Process SLA
Awareness of ISO
MS office
Typing skills, Computer skills
Good communication in English
Good analytical skills
Comprehending ability
Employement Category:
Employement Type: Full timeIndustry: Medical / HealthcareRole Category: Medical TranscriptionFunctional Area: Not ApplicableRole/Responsibilies: Claim ProcessorContact Details:
Company Name: Hinduja GlobalLocation(s): Bengaluru
Hinduja Global .
Hinduja Global Solutions Limited. Hinduja Global Solutions is an Indian pure play business and service provider headquartered in Bangalore, and part of the Hinduja Group. Formerly known as HTMT Global, the company re-branded itself as HGS in line with the group policy. It has over 44000 employee...
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