Claims Adjudication - Noida - 4ai Odc Private

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Claims Adjudication - Noida - 4ai Odc Private

4ai Odc
2 - 5 years
Noida, Gurugram
4 years ago
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Job Description

Job Description:

End-to-End adjudication of health insurance claims from the payer side checking eligibility, determining the plan benefits as per the rulebook, and final processing of the claim till the payment stage.

Proficiency in US health insurance is preferable including an understanding of ICD-9 & 10 codes, CPT codes, Modifiers, Coordination of benefits rules, types of benefit plan, etc.

Functions:

Reviews eligibility of patient as per the medical plan subscribed.
Processes the claims and makes benefit determination as per laid down procedure and guidelines
Conducts research regarding medical appropriateness, coordination of benefits issues, fraud and abuse, and third-party liability.

Academic Qualification / Education

Senior Secondary and Diploma.
Graduate or above in any of the streams.
Relevant professional certifications would carry weightage.

Additional Requirements

Proficiency in MS office tools
Ability to utilize Medical Terminology and International Classification Diagnosis (ICD-9), HCPCS & CPT coding at a level appropriate to the job
Good verbal and written communication

Shift: Day

Workdays: Mon, Tue, Wed, Thu, Fri

Working Hours: 9:00 AM to 6.00 PM IST

drop your resume: ma*************a@4a****t.com

Job Classification

Industry: Insurance
Functional Area: Other,
Role Category: Other
Role: Other
Employement Type: Full time

Education

Under Graduation: Any Graduate
Post Graduation: Any Postgraduate

Contact Details:

Company: 4AI ODC PRIVATE LIMITED
Address: B-43, SECTOR 67, NOIDA, Gautam Buddha Nagar, Uttar Pradesh, 201301, NOIDA, Uttar Pradesh, India
Location(s): Noida, Gurugram

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Keyskills: Insurance Claims Claims Adjudication Health Insurance Written Communication MS Office Tools Cpt Coding Medical Terminology

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Preferred City (* max. 2 w/comma)

Designation / Expected Role

Current / Recent Company (*)

Experience (*)

Expected Salary (*)

Desired Industry (*):

Functional area / Department (*):

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)

Please, check the file size and type.

Add social media [ + ]

Create password

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4ai Odc

4aiSoft is a Property & Casualty Insurance software solutions provider, with strong capabilities across Application Development, Analytics, Compliance management, and Claims Adjudication & related services.Claims Adjusters US Health Insurance Location: Noida, De...

Claims Adjudication - Noida - 4ai Odc Private

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