Adjudication Associate

Year    Chennai, Tamil Nadu, India

Job Description


ADJUDICATION EXPERIENCED

  • Having 0- 1years experience in claim processing.
  • 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.
  • Meet & Exceed Production, Productivity, and Quality goals
  • Process Insurance Claims timely and qualitatively
  • Review medical documents, policy documents, policy history, Claims history, and system notes and apply the trained client-level business rules to make appropriate Claims decisions, call out claims trends, and flag fraud activities.
*Having good exposure to CMS processing guidelines.
*Good Analytical skills.
*Good communication skills.
*Working knowledge of MS office tools.
*Willing to work in any shift.
  • 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.
  • Meet & Exceed Production, Productivity, and Quality goals
  • Process Insurance Claims timely and qualitatively
  • Review medical documents, policy documents, policy history, Claims history, and system notes and apply the trained client-level business rules to make appropriate Claims decisions, call out claims trends, and flag fraud activities
Eligible Criteria:

Any Degree/ Diploma

SHIFTS:

Day Shift Only

JOB LOCATION: OMR, Kottivakkam, Chennai

No of Requirements: 10

Synthesis Healthsoft Services & Solutions LLP

MOB: +91 9789780526, +91 9176332863

VENUE DETAILS

141, Prakash towers 2nd Floor, OMR ROAD, Kottivakkam, Near IGP factory,

Chennai- 600041

Expertia AI Technologies

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Job Detail

  • Job Id
    JD3078945
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    Rs.192000 per year
  • Employment Status
    Permanent
  • Job Location
    Chennai, Tamil Nadu, India
  • Education
    Not mentioned
  • Experience
    Year