Process Associate - Healthcare Claims

Job Description

With a startup spirit and 90,000+ curious and courageous minds, we have the expertise to go deep with the world&rsquos biggest brands&mdashand we have fun doing it. Now, we&rsquore calling all you rule-breakers and risk-takers who see the world differently and are bold enough to reinvent it.

Transformation happens here. Come, be a part of our exciting journey!

Are you the one we are looking for

Inviting applications for the role of Process Associate, Healthcare Claims!

In this role, you will be responsible of Data Entry of Information related to personal details, provider details, invoice information, procedure & impairment codes

Responsibilities

. The candidate will be responsible for conducting audits on healthcare claims to identify any billing aberrancy basis the clinical recommendations/judgment and review of the invoice, medical documents (if any), and payer-specific policies and guidelines

. Identify any specific billing patterns or trends from different providers monthly

. Communicate and coordinate with the clinical coordinator from client-side

. Demonstrate ability to consistently meet or exceed targets and benchmarks

. Maintain audit log and prepare and share MI from the audit log

. Handle Customer Queries from providers or members via emails.

Qualifications we seek in you!

Minimum qualifications

. Graduate (Preferably BHMS/BUMS)

. Good knowledge of healthcare & medical terminologies

Preferred qualifications

. Eye for detail & investigative skills

. Good interpretation & comprehension skills

. Excellent medical/clinical Knowledge across specialties, such as internal medicine, surgery, orthopedics, neurology, etc.

. Excellent communication skills (written & verbal)

. Demonstrable analytical skills specific to clinical audit in practice

. Customer Orientation and Solution-oriented

. Ability to ask the right queries