Executive-Back Office-Claims Administration

• Responsible for reviewing and analyzing discrepancies by cross-verifying from different data sources
• Familiar with US Healthcare domain knowledge and understanding of healthcare regulations (HIPAA)
• Deep understanding of medical coding, billing, and medical terminologies
• Attention for detail, and Strong analytical skills for processing medical documentation
• Critical thinking and high independent decision making capability
• Proficiency in healthcare information systems
• Ability to navigate through multiple applications
• Operates with urgency in a real time service environment
• Meets individual goals while assisting team to meet team goals
• Defines, communicates and manages workflow and data coordination to support various implementation related reports (i.e., reporting, inventory, capacity reporting, and ad-hoc reports as needed by management)
• May perform other duties as assigned
  
  

Desirable Skills -

• Critical thinking and high independent decision making
• Strong analytical, Reasoning, and Problem solving skills
• Medium competency in excel skills
• Ability to comprehend and write in English for structured written communications.
• Emails/IMS to be sent to internal teamsAbility to respond to all inquiries within a timely manner
• Strong interpersonal and communication skills – both verbal and written
• Adaptability/Ability to interpret variable input details
  
  

Technical Skills-

• Good computer navigation skills
• Typing speed of 25 Words per Minute with 90% Accuracy
• Proficiency in healthcare information systems
• Ability to navigate through multiple applications
  
  

Process Specific Skills -

• Familiar with US Healthcare domain knowledge and understanding of healthcare regulations (HIPAA)
• Deep understanding of medical coding, billing, and medical terminologies
• Ability to produce high quality in production in environment
• Ability to troubleshoot, identify user errors vs. system mapping errors (enrollment dates, method, system logic)
  
  

Soft skills-

• Ability to work independently
• Ability to understand and question established process guidelines for possible process improvements
• Attention for detail, and Strong analytical skills for processing medical documentation
• Possess keen sense of acquiring knowledge
• Adaptable and flexible to work in night shifts