ADJUDICATION EXPERIENCED     

•   Having 1-5 years experience in HCFA/UB claim processing.
• ·        Having good exposure to CMS processing guidelines.
• ·        Good Analytical skills.
• ·        Good communication skills.
• ·        Working knowledge of MS office tools.
• ·        Willing to work in any shift.
• 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

JOB LOCATION: OMR, Kottivakkam, Chennai

No of Requirements: 10

Synthesis Healthsoft Services & Solutions LLP

mOB: +91 97897810526, +91 9176332863