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EXL

Executives

EXL
Early Applicant
  • a month ago
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Noida, India

Job Description

Special Skills And Qualifications

  • Strong Knowledge on US Healthcare claims processing
  • Should have knowledge on manual adjudication & post pay adjudication
  • Should have knowledge of both Physician & Hospital claims
  • Knowledge on overpayment concepts or post pay audits.
  • Exposure to Hospital Contract Analysis and reimbursement methods.
  • Good communication skills
  • Strong Analytical and research skills
  • Good team player

Responsibilities And Essential Functions

  • Research for provider info, member info, contracts and intents
  • Analyze and interpret contract and payment terms
  • Identify discrepancies/gaps from the contract & payment systems
  • Reach market for clarifications if any
  • Build sequence of queries to apply on paid claims
  • Identify & validate over allowed claims and move them for audit
  • Monitor the query performance

More Info

Industry:Other

Job Type:Permanent Job

Date Posted: 08/10/2024

Job ID: 95411005

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