2.0 - 6.0 years

0 Lacs

noida, uttar pradesh

On-site

As a Dental Claims Processor at MetLife, you will be responsible for scrutinizing dental claim documents and settlements, ensuring accurate processing of claims according to healthcare guidelines and HIPAA regulations. Your role will involve handling escalations, meeting quality and productivity targets, and complying with internal policies, external regulations, and information security standards. You will need to have a good understanding of claims adjudication fundamentals, ICT & CPT Codes, and be able to learn, adapt, and implement process guidelines effectively. To qualify for this position, you should hold a Bachelor's degree in any stream or a diploma with a minimum of 15 years of education. Additionally, you should have at least 2 years of work experience in US Health Claims processing, preferably in claims adjudication. Proficiency in computer navigation, keyboarding, data entry, MS Excel, and MS Word is required. Knowledge of insurance principles related to the US Insurance industry, US culture, and dental claims terminologies will be advantageous. As a successful candidate, you must possess strong organizational and communication skills, demonstrate the ability to work independently and in a team environment, be self-disciplined, results-oriented, and have the ability to multitask. Attention to detail, a positive attitude, and being a team player are essential soft skills for this role. Joining MetLife, a globally recognized financial services company, will provide you with the opportunity to contribute to creating a more confident future for colleagues, customers, communities, and the world at large. If you are motivated by purpose and empathy, and aspire to transform the next century in financial services, MetLife welcomes you to be #AllTogetherPossible. Join us in making a difference!,

Posted 1 week ago

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Medical Coder Evaluation & Management (E&M) Access Healthcare Service

2.0 - 6.0 years

0 Lacs

noida, uttar pradesh

On-site

You will be responsible for analyzing medical records and documentation to identify services provided during patient evaluations and management. Your main task will be to assign appropriate E&M codes based on the level of service rendered and in accordance with coding guidelines and regulations such as CPT, ICD-10-CM, and HCPCS. It is crucial to ensure coding accuracy and compliance with coding standards, including documentation requirements for various E&M levels. Staying up-to-date with relevant coding guidelines, including updates from regulatory bodies like the Centers for Medicare and Medicaid Services and the American Medical Association, is essential. Adherence to coding regulations, such as HIPAA guidelines, is necessary to ensure patient privacy and confidentiality. Following coding best practices and maintaining a thorough understanding of coding conventions and principles are also key aspects of the role. Collaboration with healthcare professionals, including physicians, nurses, and other staff members, is required to obtain necessary information for coding purposes. You will need to communicate with providers to address coding-related queries and clarify documentation discrepancies. Working closely with billing and revenue cycle teams to ensure accurate claims submission and facilitate timely reimbursement is part of the job responsibilities. Conducting regular audits and quality checks on coded medical records to identify errors, inconsistencies, or opportunities for improvement is also a key aspect of the role. Participation in coding compliance programs and initiatives to maintain accuracy and quality standards is expected. To be considered for this position, applicants need to meet the following qualification criteria: - Certified Professional Coder (CPC) or equivalent coding certification (e.g., CCS-P, CRC) - In-depth knowledge of Evaluation and Management coding guidelines and principles - Proficient in using coding software and Electronic Health Record (EHR) systems - Familiarity with medical terminology, anatomy, and physiology - Strong attention to detail and analytical skills - Excellent communication and interpersonal skills - Ability to work independently and as part of a team - Compliance-oriented mindset and understanding of healthcare regulations - Strong organizational and time management abilities - Continuous learning mindset to stay updated on coding practices and changes,

Posted 2 weeks ago

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