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PE-Claims HC

0 - 1 years

1 - 3 Lacs

Coimbatore

Posted:16 hours ago| Platform: Naukri logo

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Skills Required

contract management vetting analytical strong analytical skills legal documentation agreements claims adjudication service level agreement process improvements claims processing drafting litigation claims management compliance regulations legal communication skills

Work Mode

Work from Office

Job Type

Full Time

Job Description



Job Summary

Claims Adjudication

Responsibilities

  • Process claims using ClaimsExchange and Facets ensuring accuracy and compliance with company standards.
  • Collaborate with team members to resolve any discrepancies or issues related to claims processing.
  • Maintain up-to-date knowledge of industry regulations and company policies to ensure compliance.
  • Provide timely and accurate responses to inquiries from internal and external stakeholders.
  • Analyze claims data to identify trends and areas for improvement in processing efficiency.
  • Assist in the development and implementation of process improvements to enhance claims processing.
  • Participate in training sessions to stay informed about new technologies and procedures.
  • Support the team in meeting departmental goals and objectives through effective claims management.
  • Communicate effectively with team members and management to ensure smooth workflow.
  • Utilize problem-solving skills to address and resolve claims-related issues promptly.
  • Ensure all claims are processed within the designated timeframes to meet service level agreements.
  • Contribute to the overall success of the claims department by maintaining a high level of accuracy and efficiency.
  • Engage in continuous learning to enhance skills and knowledge in claims processing. Qualifications
  • Demonstrate proficiency in using ClaimsExchange and Facets for claims processing.
  • Possess a basic understanding of Medicare and Medicaid claims processes.
  • Exhibit strong analytical skills to identify and resolve claims discrepancies.
  • Show effective communication skills for interacting with team members and stakeholders.
  • Display a keen attention to detail to ensure accuracy in claims processing.
  • Have a willingness to work night shifts in an office environment.
  • Be eager to learn and grow in the field of claims processing.

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