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Hiring For Claims adjudication Process | Sal @ Oxilum Technologies

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 Hiring For Claims adjudication Process | Sal

Job Description


Please find the below job description


Type of Program: Claims adjudication


Roles and Responsibilities

  • Perform Claims analysis based on a library of queries that are continually updated
  • Perform Provider analytics review based on claims, member risk, demographics, quality and efficiency, and provider benchmarks
  • Perform Payer analytics based on payment life cycle, bundled payments, quality and compliance, and payer benchmarks
  • Develop payment integrity logics based on the historical claims data analysis and as per the payer policies.
  • Perform continuous review of payer policies, CMS updates and coding guideline updates.
  • Create auditing logic manuals and training manuals for auditing process.
  • Monitoring of hit rates of the logics developed and make necessary changes in the existing logics.
  • Creating new logics based on the updates.
  • Responsible for each query / logic performance - findings% and appeal overturn%.
  • Maintain complete knowledge of healthcare claims processing and payment methodologies.


Qualification
Any Degree(Mandatory) Requirements

- Excellent communication skill in English


  • 2-4 yrs of Experience in Claims adjudication process.
  • Excellent verbal (voice) and written (chat & email) communication skills with least grammatical errors
  • Immediate Joiners only.

Shift


US Shift


2 Way cab and 2 Day week off


Salary

For Experienced Up to 4.5 Lac CTC + Incentives


Rounds of Interview

  • Online Assessment Test Laptop/Desktop with Webcam required to take the test
  • Technical & HR DiscussionNotice Period- Immediate Joiners only.
  • Regards
    MOHAMMED
    9790992***
    mo************m@gm**l.com

Job Classification

Industry: BPO / Call Centre
Functional Area: ITES, BPO, KPO, LPO, Customer Service, Operations,
Role Category: Voice
Role: Voice
Employement Type: Full time

Education

Under Graduation: Any Graduate
Post Graduation: Any Postgraduate
Doctorate: Any Doctorate, Doctorate Not Required

Contact Details:

Company: Oxilum Technologies
Location(s): Chennai

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Keyskills:   Insurance Claims Insurance AR Calling US Healthcare Claims Adjudication Medical Billing Claims Processing

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₹ 2,50,000 - 4,50,000 P.A

Oxilum Technologies

Oxilum Technologies Well Oxilum Technologies is a Chennai based manpower recruitment firm and training centre catering to the recruitment needs of Organizations from across Industries throughout India