Claim Processing Executive - Ahmedabad, India - Sapphire Infocom Pvt Ltd.

Sapphire Infocom Pvt Ltd.
Sapphire Infocom Pvt Ltd.
Verified Company
Ahmedabad, India

3 weeks ago

Deepika Kaur

Posted by:

Deepika Kaur

beBee Recuiter
Description

Job description

CLAIM PROCESSING EXECUTIVE / CLAIM ADJUDICATOR
[ FOR U.S.A. OPERATIONS ]

ENGLISH

MALE OR FEMALE CANDIDATE [ ONLY WITH FLUENT ENGLISH ]


JOB IS FOR INTERNATIONAL OPERATIONS




JOB TIMINGS :
5 PM TO 3 AM INDIA TIME

Sapphire have market presence globally, with footprint of our international clients in USA, Australia, Kenya, Israel etc.

We are on an exciting transformative path, with significant growth potential and a true sense of purpose.

At Sapphire, we're working to make a difference to a billion future learners and to unleash their collective potential on the world.

Our success is down to our people, and we are looking for more talented individuals to join us on that transformation.


The Role

Claim Processing Specialist:

To analyze the billing process to determine appropriateness in payment (reimbursement).

This position is responsible for handling all components of claims processing including coordination of disputed, rejected and delayed claims and to review returned, disputed or rejected claims from Medicare and other third party payers and problem solve.

This position is responsible for communicating and training the billers regarding coding processes to prevent future denials.

Our clients are in healthcare domain in USA.


Sapphire is seeking motivated individuals to join our international team in the position of Claim Processing Specialist. This role is part of a professional, supportive in global team for a location in USA providing excellent exposure to an international work environment.


What does a Claim Processing Executive do?

  • Communication skills in English to converse clearly over the telephone/meetings
  • Organization and time management to manage a variety of tasks effectively
  • Knowledge of billing policies and procedures and medical reimbursement practices and systems.
  • Ensure claims are adjudicated / adjusted as per the guidelines
  • Responsible for timely request and followup of any/all required additional information for proper claim adjudication
  • Operate within company regulations regarding HIPAA, fraud, confidentiality, and private health information guidelines
  • Interact professionally with other business units to gather and analyze data needed to properly adjudicate claims and documentation of claims files
  • Thorough understanding of the content of the medical record in order to be able to locate information to support
  • Diagnostic and procedural coding systems, common coding errors, and their impact on claims processing.
- adjudicate, and process payments for claims.

  • Effective English writing skills
  • Effective English verbal skills.

Salary:
₹35, ₹40,000.00 per month


Schedule:

  • US shift

Language:


  • English (required)

Shift availability:

  • Night Shift (required)

Work Location:
Ahmedabad Office


Salary:
₹35, ₹40,000.00 per month


Benefits:


  • Leave encashment
  • Paid time off

Schedule:

  • Monday to Friday
  • Night shift

Experience:

- total work: 1 year (preferred)
- claim processing: 1 year (required)


Speak with the employer
Expected Start Date: 15/09/2023
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