examiner should also route the claim to different department or provider / member for any
missin g information that required for claims adjudication. The claims needs to be completed
adhering to required TAT and quality SLA.
Key Roles and Responsibilities:
• In - depth Knowledge and Experience in Claims Processing.
• Should have Excellent Analytical skills to review claims based on rules and workflows.
• Need valuable comprehension skills to adjudicate claims as per Policies and Procedures.
• Should be a complete team player
K ey Performance Indicators:
• Ensuring that the key Service Level Agreements are met consistently without any
excepti ons.
• Need to achieve set Production goals.
• Adherence to departmental and company rules and regulations.
R eporting Structure:
Sr Executive – Team Leader – Manger Operations.
Success Profile:
Qualification & Experience :
Experience of 1+ year as an Claims Adjudicator.
G raduation is a must in any stream of Education
📌 Senior CSA (Chennai)
🏢 Firstsource
📍 Chennai
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