Adjudication - Claim Examiner
Job Title: Claim Examiner
Location: Chennai
Job Type: Full-Time
Shift: Day Shift “Based on the Client Requirement”
Gender: Male/ Female
Experience: Fresher
Desired Candidate Profile
• 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/ Life Science
SHIFTS:
• Day Shift Only
Benefits: ESI /PF / GRATUITY / BONUS / LEAVE ENCASH / PAID LEAVE/ INSURANCE
SYNTHESIS HEALTHSOFT SERVICES & SOLUTION LLP,
No: 141, Prakash Towers, 2nd Floor, OMR Road, Kottivakkam, Near IGP Factory,
Chennnai- 600041.
Contact Direct HR: + 91 9176332863
HR Mail ID: hr@synthesis.care