Requirements
Strong understanding of US healthcare insurance and claims lifecycle.
Good knowledge of eligibility, advantages, claims payment, denials, and adjustments.
Experience with FACETS is a solid advantage.
Strong analytical and problem-solving skills.
Excellent attention to detail and accuracy.
Responsibilities
Review and adjudicate US healthcare claims accurately and efficiently.
Verify member eligibility, advantages, coverage, and claim information.
Analyze claims to determine appropriate payment, denial, or adjustment.
Review and validate claims against benefit plans, provider contracts, and payer guidelines.
Identify and resolve claim discrepancies, exceptions, and processing errors.
Handle claim adjustments, reprocessing, and corrections as required.
📌 Sr Claims Adjudicator Facets Kochi
🏢 advenxa
📍 Kochi
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