Claims Adjudication Process

at CIEL HR Services

Claims Adjudication Process

CIEL HR Services

Company

Home

Claims Adjudication Process

at CIEL HR Services

Posted by Swati M

2 - 3 yrs

₹1L - ₹3L / yr

Coimbatore, Tamil Naidu

Skills

Claim Adjudication Process

Role: Claims Adjudication Process

Experience: 2.5-4 Years

Job Location: Coimbatore, Tamil Naidu

Work Timing: US Shift(Night Shift)

Job Description:

Claims Experience is required:

More than 3 years of experience in handling the Healthcare claims adjudication process.
Experienced level adjudicator providing analytical ability to review claim rules and workflows.
Reviews claim requests to determine eligibility for processing and escalate to management as necessary.
Responsible for the coordination and resolution of the administrative denials and appeals
Ability to understand logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.).
Ability to resolve claims that require adjustments and adjustment projects , Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
Organizing and completing tasks per assigned priorities.
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
Resolving complex situations following pre-established guidelines

Role: Claims Adjudication Process

Experience: 2.5-4 Years

Job Location: Coimbatore, Tamil Naidu

Work Timing: US Shift(Night Shift)

Job Description:

Claims Experience is required:

More than 3 years of experience in handling the Healthcare claims adjudication process.
Experienced level adjudicator providing analytical ability to review claim rules and workflows.
Reviews claim requests to determine eligibility for processing and escalate to management as necessary.
Responsible for the coordination and resolution of the administrative denials and appeals
Ability to understand logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.).
Ability to resolve claims that require adjustments and adjustment projects , Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
Organizing and completing tasks per assigned priorities.
Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
Resolving complex situations following pre-established guidelines

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About CIEL HR Services

Founded :

2015

Type :

Services

Size

Stage :

Profitable

About

CIEL HR is one of the best staffing agencies in the world with its base in India. It provides both flexible and permanent staffing services.

Lakshmi Seshagiri

Maheswari Murugan

Netra Ramshetty

shanmugapriya R

Dilika Ponnappa M

Swati M

Sivakumar S

Vinodhini Srinivasan

Bharathi S

Riya Tharakan

Aditya Mishra

Ranjini T

Jay Anil

Ragesh A C

Vishwajeet CIEL HR

karthika k

Riya CIEL HR

Anushka Madhukar

Shaktivel Naidu

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