Claim Adjudication - Chennai, India - Synthesis Healthsoft Services & solutions llp

Synthesis Healthsoft Services & solutions llp
Synthesis Healthsoft Services & solutions llp
Verified Company
Chennai, India

3 weeks ago

Deepika Kaur

Posted by:

Deepika Kaur

beBee Recuiter
Description

Claim Examiner - Adjudication

JOB SUMMARY:


  • Life Claims:
  • Processing Death Claims and identifying the right beneficiary(s) to provide the Claims benefit
  • Setting up a claim and then following up for pending requirements (if any)
  • Examining the received documents, payment calculation and settlement
  • Perform additional review before cutting the check


  • Health Claims:

  • Supporting different set of Health Claims products which includes Wellness, Critical Illness, Accident, Cancer, HI etc.
  • Check the eligibility of the member's product wise that will undergo different set of medical examination proceeding with additional care/treatment
  • To perform adjudication which will cover the additional review of the medical history proceeding with medical benefits
  • Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
  • Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team.

DESIRED CANDIDATE PROFILE:


  • Any graduate.
  • Good Analytical skills.
  • Good communication skills.
  • Working knowledge of MS office tools.
  • Willing to work in any shift.

Experienced

Any graduate.

  • Having 15 years experience in HCFA/UB claim processing.
  • Having good exposure to CMS processing guidelines.
  • Good Analytical skills.
  • Good communication skills.
  • Working knowledge of MS office tools.
  • Willing to work in any shift.

EDUCATION QUALICATIFICATION:


  • Any degree

SHIFTS:


  • Day Shift

JOB LOCATION:
Chennai


VENUE:

SYNTHESIS HEALTHSOFT
PRAKASH TOWERS, 2ND FLOOR, OMR ROAD KOTTIVAKKAM,


CHENNAI

CONTACT:
+91-XXXXXXXXXX


Salary:
₹13, ₹20,500.00 per month


Benefits:


  • Health insurance
  • Paid sick time
  • Paid time off
  • Provident Fund

Schedule:

  • Day shift

Supplemental pay types:

  • Overtime pay
  • Performance bonus

COVID-19 considerations:

ALL PRECAUTIONS HAVE TAKEN

Ability to commute/relocate:

  • Kottivakkam, Chennai ,

Tamil Nadu:
Reliably commute or planning to relocate before starting work (required)


Experience:

Claim Examiner: 3 years (preferred)


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