HC & Insurance Operations Associate

Roles and Responsibilities:\n\n * Process Adjudication claims and resolve for payment and Denials\n\n\n * Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process\n * Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations\n\n\n * Ensuring accurate and timely completion of transactions to meet or exceed client SLAs \n * Organizing and completing tasks according to assigned priorities. \n * Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team \n\n\n * Resolving complex situations following pre-established guidelines\n\n\n\nRequirements:\n\n * 1-3 years of experience in processing claims adjudication and adjustment process\n * Experience of Facets is an added advantage.\n * Experience in professional (HCFA), institutional (UB) claims (optional)\n * Both under graduates and post graduates can apply\n * Good communication (Demonstrate strong reading comprehension and writing skills)\n * Able to work independently, strong analytic skills\n\n\n\n**Required schedule availability for this position is Monday-Friday 5.30PM/3.30AM IST (AR SHIFT). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend\u2019s basis business requirement.\n