Posted:1 month ago|
Platform:
Remote
Full Time
Job Summary We are seeking a Senior Process Executive - HC with 2 to 6 years of experience in Claims Adjudication. The ideal candidate will have a strong background in healthcare processes and will be responsible for ensuring the accuracy and efficiency of claims processing. This role is work from home with a day shift schedule and no travel is required. Responsibilities Oversee the claims adjudication process to ensure timely and accurate processing of claims. Provide expertise in handling complex claims and resolving discrepancies. Collaborate with team members to streamline processes and improve efficiency. Ensure compliance with healthcare regulations and company policies. Monitor and analyze claims data to identify trends and areas for improvement. Communicate effectively with internal and external stakeholders to resolve issues. Maintain up-to-date knowledge of industry standards and best practices. Utilize technical skills to enhance claims processing systems and tools. Support the training and development of junior team members. Participate in continuous improvement initiatives to optimize claims adjudication workflows. Document and report on claims processing activities and outcomes. Contribute to the development and implementation of process improvements. Ensure a high level of customer satisfaction through effective claims management. Qualifications Possess strong technical skills in claims adjudication with a minimum of 2 years of experience. Have experience in medical management and payer domains is a plus. Demonstrate excellent analytical and problem-solving abilities. Exhibit strong communication and interpersonal skills. Show proficiency in using claims processing software and tools. Display a keen attention to detail and accuracy. Certifications Required Indian Registered Nurse Show more Show less
Cognizant
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