HC and Insurance Operations Analyst

India

Role Responsibilities:

In-depth knowledge and experience in the US healthcare (Non Voice) - Provider Data Validation and Provider Data management.
Candidate should have 3 years and above experience in US healthcare and into provider enrollment and credentialling.
Ensures day-day transactions are processed per standard operating procedures.
Follows Work process flow to ensure pends are completed and maintain Quality and timeliness standards.
Knowledge in Amisys and Cenprov application are preferred.
Product knowledge in checking affiliation for Medicaid, Medicare and Exchange.
Everyday checked Contract information in Payment Index such as, Pay class, override key, accepts code and etc.
Ability to read and understand the provider contract.
Handling Paid claims and recouped claims.
Claims Rejections handling.
Working in claims denial management.
Knowledge about End to End provider billing process.
Working knowledge in EDI rejection claims
Handing Patient and provider demographic changes.

Required Skills:

3 to 5 years of experience in US healthcare working with Provider Data Enrollment and Management.
Ability to work in a 24/5 environment; shifts can be rotational.
University degree or equivalent that required 3+ years of formal studies.
Ability to work in a team environment.
Good logical thinking ability.
Good English Comprehension/written skills should have exposure to MS Office.
Good Communication Skills - Both Verbal and Written
Ability to interact with clients preferred.

Similar jobs

No similar jobs found