Claims
Processing Executive (CPE)

Job
Summary:

We
are looking for a driven and curious Claims Processing Executive (CPE) to join
our growing dynamic medical billing team. The ideal candidate will perform all
activities involved in the preparation, insurance verification and retrieval of
medical records for US Workers’ Compensation claims. The CPE will act as the
liaison between key Client contacts and insurance companies primarily through
phone.

Key
Responsibilities:

· Analyse
and evaluate worker’s compensation claim payments using client proprietary
software, systems and tools. Use payment documentation provided by payers to
determine if the medical provider has been reimbursed in compliance with the
applicable state worker’s compensation fee schedule and/or PPO contract.

· Research,
request and acquire all pertinent medical records, implant manufacturer’s
invoices and any other supporting documentation necessary and then submit with
hospital claims to insurance companies to ensure prompt correct claims
reimbursement.

· Conduct
timely and thorough telephone follow-up with payers to ensure claims with
supporting documentation have been received and facilitate prompt
reimbursement.

· Prepare




correct Workers’ Comp initial bill packet or appeal letter using Client systems
tools and submit with all necessary supporting documentation to insurance
companies.

· Other
duties as required.

Required
Skills:

· Bachelor’s
Degree in any discipline.

· Preferred
Experience working for a US based BPO OR US healthcare insurance industry
experience OR a similar experience recommended.

· Competent
in MS Office Suite and Windows applications.

· Strong
verbal communication skills.

· Fast
and accurate typing skills while maintaining a conversation.

· Multitasking
of data entry while conversing with Client contacts and insurance companies.

· Ability
to professionally and confidently communicate to outside parties via phone,
email and fax.

· Ability
to handle large volumes of work while maintaining attention to detail.

· Ability
to work in a rapid-paced environment.

· Work
under limited supervision, manage multiple tasks and prioritize assignments
within limited time constraints.

· Effectively
communicate issues/problems and results that impact timelines for project
completion.

· Ability
to interact professionally at multiple levels within the organization.

· Timely
and regular attendance.

📌 Claims Processing Executive (Chennai)
🏢 Important Business
📍 Chennai