Back Office Executive

Job description

**Role & responsibilities** - Review incoming healthcare claims for accuracy and completeness, ensuring all necessary information is provided for adjudication. - Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial. - Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information. - Utilize claims processing systems and software to enter, update, and retrieve claims information accurately. - Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse. - Ensure timely processing of claims to meet internal and external deadlines, maintaining high levels of productivity and accuracy. - Collaborate with team members to improve claims adjudication processes and contribute to departmental goals. **Interested Candidate please share your resume at** ShanaS@hexaware.com or 9619455069