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Hi Everyone,
Freshers can also apply..
(Any Graduate)
Responsibilities
- Data Entry of Information related to personal details, provider details, invoice information, procedure & impairment codes
- Validation of information entered by indexer and data Entry Operator
- Check & select correct Pre-authorization
- Identify duplicate Claims and take appropriate action
- Reading & taking appropriate action on Alerts related to Members & providers.
- Referring case to calling team for further information
- Dealing with Policy & Non-Policy messages
- Interpreting, analysing & further investigating the Policy messages on various tools like support point, info site etc.
- Interpretation of hospital contracts & taking appropriate action basis that
- Referring cases to various department like HCS, TMT, Triage after adjudication as and when required
- Identify any over charge, ineligible chargers, contract compliance, Provider or Member Fraud
Qualifications we seek in you.
Minimum qualifications
- Graduate
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