Role & responsibilities
Review incoming healthcare claims for accuracy and completeness, ensuring all necessary information is provided for adjudication.
Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial.
Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information.
Utilize claims processing systems and software to enter, update, and retrieve claims information accurately.
Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse.
Ensure timely processing of claims to meet internal and external deadlines, maintaining high levels of productivity and accuracy.
Collaborate with team members to improve claims adjudication processes and contribute to departmental goals.
Maintain up-to-date knowledge of healthcare regulations, payer policies, and industry best practices through ongoing training and development.
Location - Ghansoli
One Way drop Faciality till home (Within boundary limit)
Please call on below number - 7900039***
Email ID - la******5@he*****e.com

Keyskills: Non Voice Backend Process Backend Operations
Hexaware BPS. is the wholly owned subsidiary of Hexaware Technologies Ltd. We are currently staffed at 4000+ people across Navi Mumbai (Mahape) Chennai, Nagpur US, Mexico and Russia. Hexaware BPS leverages on a strong technology legacy from its parent organization. With an amalgamation of passionate...