Key Responsibilities:
- Review and process healthcare insurance claims in accordance with client guidelines.
- Verify patient, provider, and claim details for completeness and accuracy.
- Identify and resolve discrepancies or missing information in claims.
- Ensure timely processing of claims to meet daily productivity and quality standards.
- Handle claim denials, rejections, and resubmissions as per standard procedures.
- Maintain proper documentation and update internal systems with claim status.
- Collaborate with team leads or supervisors to address process issues or escalations.
- Adhere to HIPAA and company data security policies at all times.
- Participate in process improvement and quality assurance initiatives.
Required Skills & Qualifications:
- Bachelor’s degree in any discipline.
- 0–3 years of experience in insurance claims processing (healthcare preferred).
- Good understanding of US healthcare insurance concepts (CPT, ICD, HCPCS codes preferred).
- Excellent written and verbal communication skills in English.
- Strong analytical and problem-solving skills.
- Basic computer knowledge with proficiency in MS Office (Excel, Word).
- Ability to work night shifts and meet strict deadlines.
Preferred Qualifications:
- Experience in claims adjudication, AR follow-up, or medical billing.
- Knowledge of EOB (Explanation of Benefits) and healthcare claim life cycle.
- Prior experience in BPO/KPO environments.
Job Type: Full-time
Pay: ₹14,000.00 - ₹16,000.00 per month
Work Location: In person