US Health Care (Voice Process) - Night Shift

Job Title: Provider Support (Inbound Voice Process)

Department: Operations

Employment Type: Full-Time

Reports To: Team Manager

Company: Integrum Outsource Solutions Private Limited

Work Shift: Night Shift

Eligibility: Only Male Candidates (Boundaries: Thane to Panvel)

Job Summary:

We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process. The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards.

Key Responsibilities:

• Analyze, review, and adjudicate provider claims.
• Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials.
• Ensure compliance with company policies, state and federal regulations, and client guidelines.
• Review claims to verify cost reasonability and medical necessity.
• Identify and report overpayments, underpayments, and other discrepancies.
• Communicate with reinsurance brokers for claim processing information.
• Verify member eligibility, benefit coverage, and authorization requirements.
• Utilize domain knowledge to solve problems and improve workflows.
• Maintain HIPAA compliance and protect confidential claim information.
• Provide process improvement suggestions and update documentation accordingly.
• Perform administrative duties as assigned.

Required Qualifications:

Experience & Skills -

• Freshers with excellent communication skills with interest in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply.
• Typing speed of at least 30 WPM.
• Effective verbal and written communication skills.
• Active listening and ability to assess customer needs.
• Critical thinking and problem-solving skills.

Work Environment & Benefits:

• Work from Office - Seawoods Darave, Navi Mumbai
• Drop Facility Available
• Competitive Salary - Rs. 20,000 to Rs. 40,000

Compliance & Adherence:

• Must comply with all company policies and procedures.
• Adherence to HIPAA regulations and healthcare compliance standards.

If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team!

Job Type: Full-time

Pay: ₹20,000.00 - ₹40,000.00 per month

Schedule:

• Night shift

Language:

• English (Preferred)

Location:

• Navi Mumbai, Maharashtra (Preferred)

Shift availability:

• Night Shift (Required)

Work Location: In person