Job Title: Specialist / Provider Control Unit (PCU) Reviewer

Location: Noida

Shift: Rotational Shifts (5 Days Work from Office)

For more info Call & WhatsApp

Poonam - (phone hidden)

Job Summary

We are looking for a Specialist / PCU Reviewer to investigate claim adjudication failures by researching provider information across multiple systems and contacting provider offices (B2B calls). The role involves updating provider records to ensure accurate and seamless claims processing.

Key Responsibilities

- Review claim adjudication failures and identify discrepancies.
- Research provider information using internal systems and databases.
- Make outbound and handle inbound B2B calls with providers and provider offices.
- Create, update, and maintain provider records.
- Validate billing and rendering provider information for accuracy.




- Document call outcomes and update system records.
- Coordinate with internal teams to resolve claim-related issues.
- Ensure compliance with company guidelines and quality standards.

Required Skills

- Excellent verbal and written English communication.
- Comfortable handling outbound and inbound B2B calls.
- Solid analytical and problem-solving skills.
- Good computer navigation and multitasking abilities.
- Ability to work on multiple applications/screens simultaneously.
- High attention to detail and decision-making skills.
- Knowledge of US Healthcare/Insurance is preferred.
- Team player with the ability to work independently.

For more info Call & WhatsApp Poonam - (phone hidden)

📌 Senior Specialist (Noida)
🏢 Anisha Global Services
📍 Noida