Job Description

Job Description: The Claims Processing Executive will be responsible for handling US health insurance Claims from healthcare providers or their authorized representatives. The executive will assist with inquiries related to advantages, eligibility, claims, authorizations, and other support services. This position requires the ability to work across various systems, deliver exceptional customer service, and ensure compliance with privacy and regulatory standards including HIPAA and other applicable guidelines Key Responsibilities:

Handles Claims related to providers/Members: Benefits, eligibility, claim status, claims adjudication, Claims Appeal and Grievances
Claim research and Explanation of Benefits (EOB)
Utilize internal systems and tools (via secure access methods) to retrieve and update information.
Document all the daily tasks related to Claims adjudicated in the system.
Escalate unresolved cases to the appropriate internal departments.
Adhere to all privacy laws and regulatory compliance requirements related to CMS and HIPAA.




Meet performance targets and service level agreements (SLAs).

Required Qualifications:

High school diploma or equivalent (mandatory)
Some college education or a completed degree (preferred)
Strong command of the English language (verbal and written)
Basic knowledge of Windows OS and Microsoft Office tools

Preferred Experience:

2–5 years of Claims Adjudication (preferably in healthcare or insurance)
Experience working in office environment with US healthcare background
Familiarity with claims processing systems and provider portals (preferred)
Experience in Medicare plans, especially on I-SNP will be an added advantage.
Clear knowledge on different types of facilities in US healthcare like SNF, NF etc.,

Skills and Competencies:

Excellent Communication: Ability to articulate clearly and listen actively
Problem Solving: Uses logic and reasoning to resolve issues effectively
Technical Proficiency: Comfortable navigating

📌 Support Engineer (Bengaluru)
🏢 Infinite Computer Solutions
📍 Bengaluru