Transaction Quality Assurance Sr. Assoc
Job Description
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 Assists with transaction processing and detects errors in transaction. Performs transactional quality based on audit parameters. Classifies errors based on the type of the error and assigns root causes for errors.
foundit
MNCJobsIndia.com will not be responsible for any payment made to a third-party. All Terms of Use are applicable.
Related Jobs
Job Detail
-
Job IdJD3049318
-
IndustryNot mentioned
-
Total Positions1
-
Job Type:Full Time
-
Salary:Not mentioned
-
Employment StatusPermanent
-
Job LocationCoimbatore, Tamil Nadu, India
-
EducationNot mentioned
-
ExperienceYear