Job Description

Job Summary

The SPE-Claims HC role requires a professional with 2 to 4 years of experience in handling appeals and grievances within the healthcare domain. The candidate will utilize their expertise in MS Excel and Excel Services on SharePoint to manage claims efficiently. This hybrid role involves rotational shifts and does not require travel.

Responsibilities

Manage and process healthcare claims with precision and accuracy to ensure timely resolution. Utilize MS Excel to analyze data and generate reports that support decision-making processes. Implement Excel Services on SharePoint to streamline data sharing and collaboration among team members. Address appeals and grievances with a focus on delivering satisfactory outcomes for all parties involved. Collaborate with cross-functional teams to enhance claims processing efficiency and effectiveness. Monitor claim trends and provide insights to improve operational strategies and reduce discrepancies. Ensure compliance with healthcare regulations and standards in all claims-related activities. Develop and maintain documentation for claims processes to ensure consistency and transparency. Provide training and support to team members on Excel and SharePoint functionalities. Assist in the development of policies and procedures to optimize claims management. Communicate effectively with stakeholders to resolve issues and improve service delivery. Participate in rotational shifts to ensure continuous support and coverage for claims operations. Contribute to the companys mission by enhancing the quality of claims processing and customer satisfaction. Qualifications Demonstrate proficiency in MS Excel for data analysis and reporting. Exhibit expertise in Excel Services on SharePoint for efficient data management. Possess strong knowledge of appeals and grievances within the healthcare domain. Showcase ability to work in a hybrid model with rotational shifts. Display excellent communication skills for stakeholder engagement. Have a keen eye for detail to ensure accuracy in claims processing. * Show adaptability to work in a dynamic and fast-paced environment.