Responsibilities:
processing insurance claims
validate members, provider and other claims information
determine accurate payment criteria for clearing pending claims based on defined policy and procedure
maintain productivity goals, quality standards and aging timeframes
scrutinize medical claim documents and settlements
involved in settlement of disputes and preparing case recovery through negotiations with the third party and providers
work as fully contributed team member under broad supervision
build up on domain expertise along with technical skills
work on complex projects which are not similar or routine based using standard concepts and principles using their knowledge and judgement
require a skilled degree along with many years of work experience
coaching/mentoring junior team members

Qualifications:
Typically requires a University Degree or equivalent experience and minimum 5 years of prior relevant experience.

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📌 Senior Analyst Claims Specialist Maharashtra
🏢 Artex Risk Solutions
📍 Maharashtra