Hiring For Claims Adjudication - US Healthcare

1 - 3 years

0 - 2 Lacs

Posted:1 week ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

Job Details:

Job Process/Role:

Experience:

Skillset:

Shift:

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Mode of Work:

Notice Period Eligible:

Roles and Responsibilities:

  • Process Adjudication claims and resolve for payment and Denials.
  • Knowledge in handling authorization, COB, duplicate, pricing, and the 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 the adjustment process.
  • Experience in professional (HCFA), institutional (UB) claims (optional).
  • Both undergraduates and postgraduates can apply.
  • Good communication (Demonstrate strong reading comprehension and writing skills).
  • Able to work independently, with strong analytical skills.

Monday-Friday, 5.30 PM/3.30 AM IST (AR SHIFT)

2. Additionally, resources may have to work overtime and on a weekend basis to meet business requirements.

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NTT DATA, Inc.

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