Job title: Claims Adjudication
Company: Ciel HR
Job description: Location: Coimbatore (People all over Tamil Nadu can apply) Notice period: Immediate US shifts Long term WFH Responsibilities: * Experienced level adjudicator providing analytical ability to review claim rules and workflows. * Reviews claim req
Location : Coimbatore (People all over Tamil Nadu can apply) Notice period: Immediate US shifts Long term WFH Responsibilities : 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. About Company: It is a top 10 global IT services provider, headquartered in Tokyo and operating in more than 50 countries. For us, work is not only for technological innovation, it is about connecting people to create better solutions for everyday life. It offers an advanced portfolio of consulting, application, business process, cloud, and infrastructure services to businesses and governments worldwide. Our roots cross continents and cultures, dating back five decades. Since the foundation of the company, we have made sustainable business growth through our DNA to be people- oriented. Through our long-term perspective, we hope to make a big difference in this world by getting the small things right. This pedigree yields a characteristic unique to the company: the opportunity for a global brand with the creative energy and enthusiasm of an entrepreneur. About CIEL HR (Payroll Company): Ciel HR marks the return of HR visionaries to the HR Services industry, powered by technology and analytics. The Founders of Ma Foi, the pioneer of the HR services sector in India, along with some of the finest brains in the HR Services Industry have envisioned and built the firm, Ciel HR, to deliver the full range of Recruiting services from Executive Search, Recruitment Process Outsourcing and Staffing Permanent as well as Temporary roles through its offices in India and the Middle East. Website:
Expected salary:
Location: India
Job date: Sat, 09 Jul 2022 22:23:36 GMT
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