Position: Claims - TL-TM-SME
Location: Kochi / Pune
Night Shift - WFO
Healthcare Operations leader with 6+ years of experience in U. S. payer-side healthcare operations across Medicare, Medicaid, Commercial, business, Claims Adjudication, Clean Claims Processing
Responsible for keying,processing and/or adjusting healthclaims inaccordance with claims policies and procedures
Good understanding of the application of benefit contracts, pricing , processing,policies procedures, govt regs, coordination of advantages, & amp; healthcare terminology.
Monitor team performance metrics including (AHT, claim resolution rate, patient satisfaction). Coach, mentor, and develop staff through regular training and performance evaluations. Collaborate with clinical and operational teams to ensure alignment with healthcare regulations (e.g., HIPAA, Claims adjudication, Case Management).
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📌 Claims specialist (Kerala)
🏢 Aptita
📍 Kerala
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