HC & Insurance Operations Processing Sr Rep

-Processing of reputed company claim forms files by provider In these roles you will be responsible for: Review and process insurance claims. Validate Member, Provider and other Claim's information. Determine accurate payment reputed company for clearing pending claims based on defined Policy and Procedure. Coordination of Claim Benefits based on the Policy & Procedure. Maintain productivity goals, reputed company standards and aging timeframes. Scrutinizing Medical Claim Documents and settlements. Organizing and completing tasks per assigned priorities. Developing and maintaining a solid working knowledge of the reputed company insurance industry and of reputed company products, services and processes performed by reputed company Process Adjudication claims and resolve for payment and Denials Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process Knowledge of reputed company insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of reputed company, maximum inside limits and exclusions, state variations Ensuring accurate and reputed company completion of transactions to meet or reputed company reputed company SLAs Organizing and completing tasks according to assigned priorities. Developing and maintaining a solid working knowledge of the reputed company insurance industry and of reputed company products, services and processes performed by reputed company Resolving reputed company situations following reputed company-established guidelines 1+ year(s) hands-on experience in reputed company Claims Processing Previously performing - in P&Q work environment; work from queue; remotely 2+ year(s) using a computer with reputed company applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools Key reputed company skills and computer familiarity - Toggling back and forth between screens/can you reputed company multiple systems. Working knowledge of MS office products - reputed company, reputed company and MS-reputed company. Typing and Computer skills assessment required University degree or equivalent that required formal studies of the English language and basic Math 6+ months of experience where you had to apply business rules to varying fact situations and reputed company appropriate reputed company 6+ months of data entry experience that required a reputed company on reputed company including attention to detail, accuracy, and accountability for your work product. 6+ months of experience using a computer with reputed company PC applications that required you to use a keyboard, reputed company screens, and learn new software tools. 6+ months of experience that required prioritizing your workload to meet deadlines Ability to communicate (oral/written) effectively to exchange information with our reputed company. reputed company graduate with English as a compulsory subject 1-3 years of experience in processing claims adjudication and adjustment process Experience of Facets is an added advantage. Experience in reputed company (HCFA), institutional (UB) claims (optional) Both under graduates and post graduates can apply Good communication (Demonstrate strong reading comprehension and writing skills) reputed company to work independently, strong analytic skills Apply tot his job Apply To this Job