PE-Claims HC

0 - 1 years

1 - 3 Lacs

Posted:1 week ago| Platform: Naukri logo

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Job Type

Full Time

Job Description



Job Summary

Join our dynamic team as a PE-Claims HC specialist where you will play a crucial role in processing and adjudicating claims with precision and efficiency. This hybrid role requires a keen understanding of Medicare and Medicaid claims ensuring compliance and accuracy. With a focus on night shifts you will contribute to our mission of delivering exceptional healthcare solutions without the need for travel.

Responsibilities

  • Process claims with a high degree of accuracy ensuring compliance with Medicare and Medicaid regulations.
  • Analyze claims data to identify discrepancies and resolve issues promptly.
  • Collaborate with team members to streamline claims adjudication processes.
  • Maintain up-to-date knowledge of industry standards and regulatory changes.
  • Utilize technical skills to enhance claims processing efficiency.
  • Communicate effectively with stakeholders to ensure clarity and understanding of claims processes.
  • Implement best practices to improve overall claims management.
  • Monitor claims processing metrics to ensure timely and accurate adjudication.
  • Provide feedback and suggestions for process improvements.
  • Support the team in achieving departmental goals and objectives.
  • Ensure all claims are processed within established timelines.
  • Assist in the development of training materials for new team members.
  • Contribute to a positive work environment by fostering collaboration and teamwork.

  • Qualifications

  • Possess strong analytical skills to assess and adjudicate claims accurately.
  • Demonstrate proficiency in claims adjudication processes and tools.
  • Exhibit a solid understanding of Medicare and Medicaid claims requirements.
  • Show excellent communication skills to interact with various stakeholders.
  • Have the ability to work effectively in a hybrid work model.
  • Display a keen attention to detail to ensure compliance and accuracy.

  • Certifications Required

    N / A

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