Claim Adjudication - Chennai, India - Synthesis Healthsoft Services & solutions llp
1 month ago
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)
Speak with the employer
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