Hiring US Healthcare Process (Claim/Adjudication)- Navi Mumbai

Job description

Role & responsibilities :- **Hiring: US Healthcare Claims Processor** **Location:** Navi Mumbai **Working Days:** 5-Day Work Week **Transport:** One-Way Drop Facility (As per company boundary limits) **Key Responsibilities:** - Review incoming healthcare claims for accuracy and completeness, ensuring all required information is available for adjudication. - Analyze claims against payer policies, contractual guidelines, and industry regulations to determine eligibility for payment or denial. - Communicate with healthcare providers, policyholders, and internal teams to resolve discrepancies and obtain missing information. - Utilize claims processing systems to accurately enter, update, and retrieve claims data. - Identify and report trends or patterns that may indicate potential fraud, waste, or abuse. - Process claims within defined turnaround times while maintaining high levels of accuracy and productivity. - Collaborate with team members to improve claims adjudication processes and achieve departmental objectives. - Stay updated on healthcare regulations, payer policies, and industry best practices through ongoing training and development. **Requirements:** - Experience in US Healthcare Claims Processing / Claims Adjudication. - Strong analytical and problem-solving skills. - Good communication and interpersonal skills. - Ability to work accurately in a fast-paced environment. - Proficiency in using claims processing systems and related applications. **Interested candidates can share their updated resume at:** **Lakshmis5@hexaware.com** **Contact:** 7900039652