In this Role you will be Responsible For :
Review & Processes Healthcare payer claims including HCFA & UB forms.
Validate Member, Provider and other Claims information.
Resolve multiple hold codes/edits to complete a transaction
Need to verify and understand the healthplan documents to take decision on benefits allowed
Strong knowledge on all claims type like COB, corrected submission etc.
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
Organizing and completing tasks according to assigned priorities.
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
Resolving complex situations following pre-established guidelines
Requirements for this role include:
MNCJobsIndia.com will not be responsible for any payment made to a third-party. All Terms of Use are applicable.