Hiring Immediate Joiners||min 1yr exp in Claim
- Calibrated Healthcare
- 1 - 5 years
- Noida, Gurugram
- 5 years ago
- Email to a friend
- Report this job
Job Description
Greetings for the Day!
Position Overview:
The position would be reporting to the Claims Manager/Supervisor India Operations. Will be responsible and accountable to support organizational goals and follow all processes with a focus on Claims Adjudication. This Claims processing role will include reviewing and adjudicating claims based on provider and health plan contractual agreements and claims processing guidelines, coordinating benefits other health insurance, duplicate claims, and manual processing to ensure the accurate and timely processing of all claims. Will work as part of a team to meet Service Level Agreements (SLAs) in accordance with client contracts, established departmental and governmental guidelines.
Job Duties and Base Skill-set:
Responsible for processing CMS 1500 claims for all Lines of Business and specialty types of care.
Responsible for maintaining all departmental policies and procedures, ensuring that they are followed and ensure they are followed when carrying out day- to-day operations.
Understand how to track production, error trending, follow workflow procedures and respond to corrective-actions on personal performance.
Receive direction and training on extensive claim research, claim development, claim problem analysis, and claim payments.
Participate with team on a regular basis to ensure all members within the teams are working appropriately and operating to achieve efficient productivity.
Possesses a thorough understanding of team environment and can work and support a group consensus when decisions are made.
Collaborates and supports managers to enhance technology and service delivery to include analyzing, proposing, testing, implementing, training, maintaining and monitoring in order to continuously improve customer satisfaction levels, operational effectiveness and cost efficiencies
Education and Experience
Bachelor's Degree in Business Administration, Health Care or another related field
Minimum 1+ years of experience in US Healthcare that directly aligns with the specific responsibilities for this position (Claims adjudication) and 2+ years experience in Medical Billing. Well-versed with HMO Plans & PPO Plans
Strong communication skills (verbal and written), and technical skills in Microsoft office to include Excel, Imaging Systems.
Must have a thorough understanding of claims operations, including, but not limited to, prior roles as adjuster/examiner, claims operations, or equivalent. Ability to understand provider contracts. Thorough knowledge of HIPAA.
Demonstrated ability to function effectively as a team-player, and able to work independently.
Proven time management skills; must be resourceful in developing alternative solutions and meeting deadlines in a real time, fast paced environment.
Typing speed Should be minimum 30 wpm, must be presentable.
Interested candidates can directly share their resume to jo*s@ca*****************e.com
Regards
Neharika Jain
HR- Talent Acquisition.
Job Classification
Industry: BPO / Call CentreFunctional Area: ITES, BPO, KPO, LPO, Customer Service, Operations, Role Category: VoiceRole: VoiceEmployement Type: Full timeEducation
Under Graduation: Any Graduate in Any SpecializationPost Graduation: Post Graduation Not RequiredDoctorate: Doctorate Not RequiredContact Details:
Company: Calibrated Healthcare Systems India Pvt. LtdAddress: 516,,,PHASE-3,UDYOG VIHAR, GURGAON, Haryana, IndiaLocation(s): Noida, Gurugram
Keyskills: US Healthcare Claims Adjudication Claims Processing Excel HIPAA MS Office Medical Billing Operations Provider Health Insurance
Calibrated Healthcare
Calibrated Healthcare Network (CHN) is a decade old healthcare firm that provides a suite of services across three service lines; Healthcare Administration, Medical Management, and Population Health Management. Calibrated's unique Operating Model combines acclaimed clinical/operational le...
Job Listings
We are in open beta version of website, please let us know if any issues, at: info(at)indigojobs.in