Role & responsibilities

Selected Candidates Will be trained on the claim adjudication process

They will evaluate and processes claims in accordance with company policies and procedures per CMS guidelines/SOP

Reviews and analyzes data for in-process claims in order to identify and resolve errors prior to final adjudication

Exercises good judgment and remains knowledgeable in related company policies and procedures

Achieves teamwork, production and quality standards in order to assure timely, efficient and accurate claims processing

Gain knowledge of Commercial, Medicaid, Medicare & TPA claims processing guidelines

Knowledge of medical coding/billing including ICD-10, CPT, CMS-1500, UB-04, etc.

Knowledge of different providers' payment methodologies (i.e., capitation, fee for service based on RBRVS, Medicaid and other negotiated flat rates,



RVS pricing, Per Diem, DRG pricing, etc.) preferred

Pay or deny per the guidelines/SOP

Preferred candidate profile

Maintain confidentiality of all information, policies, and procedures as required by the Health Insurance Portability and Accountability Act (HIPAA) protocols

Flexibility with shift according to client need is mandatory

He will report to the team lead.

A two-wheeler is mandatory

Fresher with valuable analytical and communication

Preferred candidate profile Fresher who can work in NIGHT SHIFTS (US shift timings) Company transport not available

Perks and perks: ESI and PF perks. Friendly work culture

📌 Freshers Claim Adjudication Male Candidates Chennai
🏢 Neltner Business Services
📍 Chennai