Job Description

Job Summary

We are seeking a dedicated professional for the role of TL-Claims HC with 5 to 7 years of experience. The candidate will be responsible for overseeing claims adjudication processes ensuring accuracy and efficiency. This hybrid role requires expertise in MS Office and UiPath with a strong understanding of payer and provider domains. The position involves night shifts offering an opportunity to contribute to our mission of enhancing healthcare services.

Responsibilities

Oversee the claims adjudication process to ensure accuracy and compliance with industry standards. Implement and optimize automation solutions using UiPath to streamline claims processing. Collaborate with cross-functional teams to enhance the efficiency of claims management. Analyze claims data to identify trends and areas for improvement in the adjudication process. Provide training and support to team members on best practices in claims adjudication. Develop and maintain documentation for claims processing procedures and automation workflows. Ensure adherence to payer and provider guidelines to maintain compliance and quality standards. Utilize MS Office tools to generate reports and presentations for management review. Monitor and evaluate the performance of claims processing systems to identify potential enhancements. Coordinate with IT teams to resolve technical issues related to claims processing systems. Engage with stakeholders to gather feedback and implement process improvements. Support the development of strategies to reduce claim processing times and improve customer satisfaction. Maintain up-to-date knowledge of industry regulations and trends to ensure compliance.

Qualifications

Demonstrate proficiency in MS Office applications for data analysis and reporting. Exhibit expertise in UiPath for developing and managing automation solutions. Possess in-depth knowledge of claims adjudication processes and best practices. Showcase experience in the payer and provider domains to ensure effective claims management. Display strong analytical skills to identify and address process inefficiencies. * Communicate effectively with team members and stakeholders to drive process improvements.