Job Description:

Key Responsibilities
- Responsible for reviewing and analyzing discrepancies by cross-verifying from different data sources
- Familiar with US Healthcare domain knowledge and understanding of healthcare regulations (HIPAA)
- Deep understanding of medical coding, billing, and medical terminologies
- Operates with urgency in a real time service environment
- Defines, communicates and manages workflow and data coordination to support various implementation related reports (i.e., reporting, inventory, capacity reporting, and ad-hoc reports as needed by management)
- Review and evaluate medical insurance claims and documents.
- Analyze clinical information and medical reports for claim validation.
- Ensure accurate processing of claims as per policy guidelines.
- Maintain proper documentation and records.
- Coordinate with internal teams for claim-related queries.
- Adhere to process guidelines, quality standards, and TAT.

Eligibility Criteria

Educational Qualification:
- Qualified BPT, BDS, BMLT, BAMS, BHMS, BUMS
- B. Pharma (minimum 6 months experience required)





Experience:
- Minimum 6 months of relevant claims experience preferred.
- Freshers considered with qualifications BPT, BDS, BMLT, BAMS, BHMS, BUMS would be considered.

Skills Required
- Familiar with US Healthcare domain knowledge and understanding of healthcare regulations (HIPAA)
- Deep understanding of medical records and medical terminologies
- Ability to produce high quality in production setting.
- Basic knowledge of medical terminology and healthcare processes.
- Understanding of medical insurance and claims processing.
- Valuable analytical and decision-making skills.
- Good computer knowledge and documentation skills.
- Typing speed of 25 Words per Minute with 90% Accuracy
- Proficiency in healthcare information systems
- Ability to navigate through multiple applications
- Ability to understand and question established process guidelines for possible process improvements
- Attenti

📌 Medical Claims (Noida)
🏢 Mancraft Consulting
📍 Noida