Adjudication - Claim Examiner

Desired Candidate Profile

• 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

Experience :

·      Fresher to 1 Years

Thanks & Regards

HR Department

Synthesis Healthcare Services LLP

Mob : 9176332863, 938468539