Hiring For Claims adjudication Process | Sal @ Oxilum Technologies

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

Education

Contact Details:

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Rs 0 - 50K PM Rs 50K - 1 LPA Rs 1.0 - 1.5 LPA Rs 1.5 - 2.0 LPA Rs 2.0 - 2.5 LPA Rs 2.5 - 3.0 LPA Rs 3.0 - 3.5 LPA Rs 3.5 - 4.0 LPA Rs 4.0 - 4.5 LPA Rs 4.5 - 5.0 LPA Rs 5 - 6 LPA Rs 6 - 7 LPA Rs 7 - 8 LPA Rs 8 - 9 LPA Rs 9 - 10 LPA Rs 10 - 12 LPA Rs 12 - 14 LPA Rs 14 - 16 LPA Rs 16 - 18 LPA Rs 18 - 20 LPA Rs 20 - 22 LPA Rs 22 - 24 LPA Rs 24 - 26 LPA Rs 26 - 28 LPA Rs 28 - 30 LPA Rs 30 - 32 LPA Rs 32 - 34 LPA Rs 34 - 36 LPA Rs 36 - 38 LPA Rs 38 - 40 LPA Rs 40 - 42 LPA Rs 42 - 44 LPA Rs 44 - 46 LPA Rs 46 - 48 LPA Rs 48 - 50 LPA Rs 50 - 75 LPA Rs 75 Lakh - 1C PA Rs 1 Crore+ PA

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