Claims Associate @ Quess Corp Magna

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Claims Associate

Quess Corp Magna
0 to 1 Yr
Hyderabad
5 years ago
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Job Description

The Denial Associate is responsible for addressing and resolving insurance claims that are unpaid. Analyze benefit requests and secure all necessary data to ensure appropriate implementation
based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.

Responsibilities:

Work with Client Management to implement new and maintain existing benefit plans
and client pricing in the pharmacy claim adjudication system.
Work with Pharmacy Network Management to implement pharmacy rate changes
and network additions in the pharmacy claim adjudication system.
Ensure timely communication of any issues and/or information needed to complete a
plan request.
Develop client specific implementation plans and manage implementation processes
in accordance with department protocol.
Perform claim testing to ensure accurate claim adjudication.
Adhere to all documentation standards within the department.

Required Qualification:

Good knowledge on understating claim processing, EOBs, ICD, CPT & modifiers, edits /rejections, clearing house.

Qualification : B. pharma , M. Pharma

Employement Category:

Employement Type: Contract
Industry: Pharma / Biotech
Role Category: Pharmacist / Medical Representative
Functional Area: Not Applicable
Role/Responsibilies: Claims Associate

Contact Details:

Company: Quess Corp Magna
Location(s): Hyderabad

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Enter Skills (key skills, subjects, technologies & roles to use in search)

Write briefly about yourself, your experience and education (*)

Attach ResumeMax 2.38 MB (RTF, PDF, DOC, DOCX formats only parsed)

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Quess Corp Magna

Magna Infotech is a division of USD 400 + million Quess Group (quesscorp.com) which in turn is a subsidiary of USD 37+ billion - Canadian Multinational, Fairfax Financial Holding Group. Magna Infotech is the largest staff Augmentation and Solutions Company in India, USA and APAC regions. We are a ...

Claims Associate @ Quess Corp Magna

Home > Pharmacist / Medical Representative