Hc & Insurance Operations Associate
Year Gurugram, Haryana, 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 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
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Job IdJD3020290
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationGurugram, Haryana, India
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EducationNot mentioned
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ExperienceYear