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Adjudication Associate

Chennai
Full-Time
Junior: 1 to 3 years
15K - 16K (Per Month)
Posted on Feb 16 2023

Not Accepting Applications

About the Job

Skills

HCFA
UB CLAIM
Claims Management
cms processing Guidelines

ADJUDICATION EXPERIENCED    


  •   Having 0- 1years experience in claim processing.
  • 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.
  • ·        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 9789780526, +91 9176332863


VENUE DETAILS

141, Prakash towers 2nd Floor, OMR ROAD, Kottivakkam, Near IGP factory,

Chennai- 600041


About the company

Synthesis HealthSoft Services & Solutions LLP is a premier BPO company capable of providing end-to-end healthcare services to both payers and providers. To combat rising healthcare costs, shortage of skilled and certified resources, ever-changing regulations, rising technology costs, and increasing market competition, corporations are looking to outsource functions to a location where these challe ...Show More

Industry

Healthcare & BPO

Company Size

201-500 Employees

Headquarter

Chennai

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