Job title: Claims Processor
Company: Ciel HR
Job description: Location: Coimbatore-WFH Long term Shift: US Night Shift. Skills Expectation: * Experienced level adjudicator providing analytical ability to review claim rules and workflows. * Reviews claim requests to determine eligibility for processing a
Location: Coimbatore-WFH Long term Shift: US Night Shift. Skills Expectation: 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 Having Hands on experience in PDM(Provider Data Management) 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
Expected salary:
Location: India
Job date: Mon, 11 Jul 2022 22:01:04 GMT
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