ADJUDICATION EXPERIENCED
- Having 1-5 years experience in HCFA/UB claim processing.
- Having good exposure to CMS processing guidelines.
- Good Analytical skills.
- Good communication skills.
- Working knowledge of MS office tools.
- Willing to work in any shift.
- 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.
- Meet & Exceed Production, Productivity, and Quality goals
- Process Insurance Claims timely and qualitatively
- Review medical documents, policy documents, policy history, Claims history, and system notes and apply the trained client-level business rules to make appropriate Claims decisions, call out claims trends, and flag fraud activities
Eligible Criteria:
Any Degree/ Diploma
SHIFTS:
Day Shift Only
JOB LOCATION: OMR, Kottivakkam, Chennai
No of Requirements: 10
Synthesis Healthsoft Services & Solutions LLP
mOB: +91 97897810526, +91 9176332863
