Role & responsibilities

- Review incoming healthcare claims for accuracy and completeness, ensuring all necessary information is provided for adjudication.
- Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial.
- Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information.
- Utilize claims processing systems and software to enter, update, and retrieve claims information accurately.
- Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse.
- Ensure timely processing of claims to meet internal and external deadlines, maintaining high levels of productivity and accuracy.

Interested candidates can share their resume at [email protected] or (phone hidden)

Role: Back Office Operations, Industry Type: BPM / BPO, Department: Customer Success, Service & Operations, Employment Type: Full Time, Permanent Role Category: Back Office Education UG: Any Graduate read more

Key Skills Skills highlighted with ‘‘ are preferred keyskills Claims Processing

📌 Claims Executive (Thane)
🏢 Hexaware Technologies
📍 Thane