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About the Job
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
• Any Degree/ Diploma
• Day Shift Only
· Fresher to 1 Years
Thanks & Regards
Synthesis Healthcare Services LLP
Mob : 9176332863, 938468539