Hc & Insurance Operations Assoc

Year    Coimbatore, Tamil Nadu, India

Job Description


Roles and Responsibilities:

  • Process Adjudication claims and resolve for payment and Denials
  • Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
  • Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations
  • Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
  • Organizing and completing tasks according to 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:
  • 1-3 years of experience in processing claims adjudication and adjustment process
  • Experience of Facets is an added advantage.
  • Experience in professional (HCFA), institutional (UB) claims (optional)
  • Both under graduates and post graduates can apply
  • Good communication (Demonstrate strong reading comprehension and writing skills)
  • Able to work independently, strong analytic skills
**Required schedule availability for this position is Monday-Friday 5.30PM/3.30AM IST (AR SHIFT). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend\'s basis business requirement.

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Job Detail

  • Job Id
    JD3358782
  • Industry
    Not mentioned
  • Total Positions
    1
  • Job Type:
    Full Time
  • Salary:
    Not mentioned
  • Employment Status
    Permanent
  • Job Location
    Coimbatore, Tamil Nadu, India
  • Education
    Not mentioned
  • Experience
    Year