Urgent Hiring For Claims Adjudication Process
- CIEL HR services
- 2 - 4 years
- Chennai
- 4 years ago
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Job Description
Job description
Experience: 2.5 Years - 4 Years
Job Location: Coimbatore, Tamil Naidu (Remote)
Shift : US Shift Only ( Night Shift ).
Notice Period : Immediate Joiner
Job Type : CIEL HR Payroll
Role & Responsibilities :
- 2+ year(s) of experience processing claims for the US healthcare market (Mandatory to have)
- Knowledge of HRP added advantage.
- 6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions added advantage
Claims Experience is required:
- More than 3 years of experience in handling the Healthcare claims adjudication process.
- Experienced level adjudicator providing analytical ability to review claim rules and workflows.
- Reviews claim requests to determine eligibility for processing and escalate to management as necessary.
- Responsible for the coordination and resolution of the administrative denials and appeals
- Ability to understand logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.).
- Ability to resolve claims that require adjustments and adjustment projects , Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
- Organizing and completing tasks per assigned priorities.
- Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
- Resolving complex situations following pre-established guidelines
Requirements for this role include:
- University degree or equivalent that required formal studies of the English language and basic Math
- 2+ year(s) of experience processing claims for the US healthcare market
- Knowledge of HRP added advantage.
- 6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions added advantage
- 6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
- 6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
Interested candidate can reach out to me @pa*********e@ci***r.com
Job Classification
Industry: BPO / Call CentreFunctional Area: Healthcare & Life Sciences, Role Category: Health InformaticsRole: Health InformaticsEmployement Type: Full timeEducation
Under Graduation: Any GraduatePost Graduation: Post Graduation Not RequiredDoctorate: Any Doctorate, Doctorate Not RequiredContact Details:
Company: CIEL HR Services Pvt LtdLocation(s): Chennai+ View Contact
Keyskills: claims processing us shift claims adjudication US Healthcare Health Insurance Medical Billing
Fraud Alert to job seekers!
₹ 1,50,000 - 2,75,000 P.A
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