All the rest of countries except US claims are getting loaded in the portal (Octopus) in paper /electronic format.
We have 2 baskets where the claims are pended.
The coding basket has claims which are mainly for coding process to be performed and claim review basket to work on review (Coding, Cost review, MNR, IBR).
We have a portal (Health cloud) for further information/ communication and pre authorizations.it helps us to converts the unstructured forms to structured format.
The complex process are performed on health cloud (MNR, IBR, Cost Savings) Trained Nurses & Dentist with claims processing skills would pick up these claims and load them into the CAS (Mainframe) and follow all the workflows to load / process and adjudicate these claims for payments.
Qualification & Skills:
BDS Graduate
(Mandatory)
Astute understanding of MS Office Tools
Displays a High Level of Integrity and Maturity
Displays high level of People Management practices
Displays High level of Communication Skill
Shift: U.S Shift (1:30 PM - 10:30PM)
Location: Bangalore
Working Hours: 5 Days weekly (Sat & Sun Fixed Weekoff)