US Health Care (Voice Process) - Night Shift

Job Description

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