Urgent Opening For US healthcare Process - Back Office

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. • Maintain up-to-date knowledge of healthcare regulations, payer policies, and industry best practices through ongoing training and development. Location - Ghansoli One Way drop Faciality till home (Within boundary limit) Please call on below number - 7900039652 Email ID - lakshmis5@hexaware.com