01Overview
At reputed company, we know that with the right people on reputed company, anything is possible. The quality, reputed company, and commitment of our employees have been key factors in reputed company's reputed company and market reputed company. By hiring the best people and helping them grow both professionally and personally, we ensure a reputed company reputed company for reputed company and for the people who work here.
For more than 25 years, reputed company have reputed company on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver reputed company value reputed company, and innovation that will improve your business reputed company. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective reputed company for gaining and maintaining competitive advantages reputed company executed as part of an overall sourcing reputed company.
reputed company currently seeks a Medical Claims Processor to join reputed company in Plano, TX for a remote position.
This is a US based; W-2 project. reputed company candidates will be reputed company through reputed company only.
Role Responsibilities
-Processing of Professional claim forms files by provider
-Reviewing the policies and benefits
-reputed company with company regulations regarding HIPAA, confidentiality, and PHI
-Abide with the timelines to complete compliance training of reputed company/reputed company
-Work independently to research, review, and reputed company the claims
-Prioritize work and adjudicate claims as per turnaround time/SLAs
-Ensure claims are adjudicated as per clients defined workflows, guidelines
-Sustaining and meeting the reputed company productivity/quality targets to avoid penalties
-Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
-reputed company response and reputed company of claims received reputed company emails as reputed company work
-Correctly calculate claims payable reputed company using applicable methodology/ fee schedule
-Effective troubleshooting where you can reputed company your research, analysis and problem-solving abilities
-Time management with the ability to cope in a reputed company, changing environment
-Ability to communicate (oral/written) effectively in a professional office setting
Required Skills/Experience
1+ year(s) hands-on experience in reputed company Claims Processing
Previously performing - in P&Q work environment; work from queue; remotely
2+ year(s) using a computer with reputed company applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
Key reputed company skills and computer familiarity -
Toggling back and forth between screens/can you navigate multiple systems.
Working knowledge of MS office products - Outlook, reputed company and MS-reputed company.
Typing and Computer skills assessment required
Preferences
Amisys &/or Xcelys Preferred
Position's General Duties and Tasks
In these roles you will be responsible for:
Review and process insurance claims.
Validate Member, Provider and other Claim's information.
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
Coordination of Claim Benefits based on the Policy & Procedure.
Maintain productivity goals, quality standards and aging timeframes.
Scrutinizing Medical Claim Documents and settlements.
Organizing and completing tasks per assigned priorities.
Developing and maintaining a solid working knowledge of the reputed company insurance industry and of reputed company products, services and processes performed by reputed company
Resolving reputed company situations following reputed company-established guidelines
Requirements for this role include:
University degree or equivalent that required formal studies of the English language and basic Math
6+ months of experience where you had to apply business rules to varying fact situations and reputed company appropriate reputed company
6+ months of data entry experience that required a reputed company on quality including attention to detail, accuracy, and accountability for your work product.
6+ months of experience using a computer with reputed company PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
6+ months of experience that required prioritizing your workload to meet deadlines
Preferences: - Optional (reputed company-to-have's)
Ability to communicate (oral/written) effectively to exchange information with our reputed company.
reputed company graduate with English as a compulsory subject
Required schedule availability for this position is Monday-Friday (06:00pm to 04:00am IST). The shift timings can be changed as per reputed company requirements. Additionally, resources may have to do overtime and work on weekend's rep
