About this role
Job title: Claims Examiner
About the Role Claims Examiner role focused on analyzing documents and contracts to determine payment decisions per client specifications. The role also involves routing claims to appropriate departments or providers for any missing information required for adjudication, with completion adhering to specified turnaround times and quality standards.
What You'll Do
- Analyze documents/contracts to decide pay/deny outcomes according to client specifications.
- Route claims to relevant departments/providers for missing information required for adjudication.
- Ensure claims adjudication is completed within required turnaround times and quality standards.
- Support production/quality processes and maintain shift adherence; apply process knowledge.
What We're Looking For
- Graduation in Arts & Science or Diploma (Any discipline) with 3 years of study, without arrears; BE/B.Tech & Masters are not eligible.
- Good comprehension skills; Typing speed of 24 WPM with 90% accuracy.
- Good communication skills; Listening & Comprehension.
- Ability to work in a claims processing environment and adhere to service level agreements.