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Job title
Senior (Sr.) Transaction Processing Officer Claims Registration (Band 5, Level 3) SME
Reports to
Unit Manager / Asst Unit Manager
Job purpose
Provides customer service support for third party administrators, Health Maintenance organizations, preferred provider organizations, managed care organizations and many more in US healthcare insurance market by identifying and updating information.
The ultimate motive is to ensure commendable service standards and maintain very high customer satisfaction.
Duties and responsibilities
Listed below are the primary job duties and responsibilities that are required:
? Primary responsibility is to key claim details from claim images into the healthcare software.
? Staying current with knowledge of products/ processes & services offered by the client
? Ensure full adherence to all the quality parameters.
? Ensure 100% adherence to schedule.
? Meeting all defined targets like Productivity, quality, Maintenance of required reports in Excel.
Essential Job Functions
? Look up for relevant information and update (type into) the client systems as per set procedures and policies.
? Attention to detail while accomplishing tasks, meeting Weekly / Daily targets with required quality in the given timelines
? Enter updates relating to pertinent healthcare data into the computer system in a timely manner ensuring accuracy, completeness, and adherence to department procedures.
? Review data for deficiencies or errors, correct any incompatibilities if possible.
? Adhere to the team norms for making the overall team a cohesive one.
? Ability to prioritize and manage workload.
? Must be ready to work in night shifts
Experience and Skills requirement for this role:
? Minimum One (1) year experience in examining and processing claims required.
? Experience and knowledge in Provider Maintenance, Enrollment process, Claims Data Entry.
? Medical claims processing (Claims Adjudication) experience and in-depth knowledge a must.
? Should be good with MS Office and training reporting.
Qualification Requirement
? Undergraduate (10+2)/Diploma / Graduate (Only Arts or Science) - Non-Technical Only
? Typing speed 35 to 40 wpm with 95% accuracy (without looking at the keyboard)
? Good communication skills.
Skills:
PRIMARY COMPETENCY : Health Care PRIMARY SKILL : Transaction Processing PRIMARY SKILL PERCENTAGE : 100
About Company:
Mphasis is a leading IT solutions provider, offering Applications, Business Process Outsourcing (BPO) and Infrastructure services globally through a combination of technology knowhow, domain and process expertise. The accolades we have been garnering can be attributed to our undeterred focus in delivering quality solutions across verticals that meet the challenging requirements of our esteemed customers. We have been recently felicitated by the economic times as the most distinguished digital company 2015. We have also been ranked 29 of 100 largest financial technology vendors by American Banker and BAI in the FinTech Forward Top 100 rankings.
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