07 Aug
|
Allegis Group
|
India
07 Aug
Allegis Group
India
Role & responsibilities
Process and adjudicate US healthcare insurance claims as per payer guidelines and policies.
Review Qualified, Inpatient, Outpatient, Skilled Nursing, and Maternity claims.
Verify member eligibility, perks, coverage, and authorizations.
Handle Medicare, Medicaid, and Coordination of Perks (COB) claims.
Perform claim validation, payment calculations, settlements, and denial reviews.
Investigate and resolve claims-related discrepancies and exceptions.
Conduct overpayment recovery and claims audit activities.
Ensure compliance with healthcare regulations, client requirements, and quality standards.
Collaborate with internal teams, providers, payers, and other stakeholders to resolve claim-related issues.
Maintain productivity, accuracy, and SLA target
📌 Program Specialist Bengaluru (India)
🏢 Allegis Group
📍 India