HC & Insurance Operations Associate

Roles and Responsibilities:
•    Process Adjudication claims and resolve for payment and Denials
•    Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
•    Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations
•    Ensuring accurate and timely completion of transactions to meet or exceed client SLAs 
•    Organizing and completing tasks according to assigned priorities. 
•    Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team 
•    Resolving complex situations following pre-established guidelines
Requirements:
•    1-3 years of experience in processing claims adjudication and adjustment process
•    Experience in professional (HCFA), institutional (UB) claims (optional)
•    Both under graduates and post graduates can apply
•    Good communication (Demonstrate strong reading comprehension and writing skills)
•    Able to work independently, strong analytic skills

**Required schedule availability for this position is Monday-Friday 5.30PM/3.30AM IST (AR SHIFT). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend’s basis business requirement.