Job Responsibilities:
- Review claim rules and workflows
- Reviews claim requests to determine eligibility for processing and escalate to management on a case to case basis
- Organizing and completing tasks per 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
Desired Skills & Qualification:
- University degree or equivalent that required 3+ years of formal studies
- 2 + years of experience processing claims for the US healthcare market
- Ability to understand logic of standard Payment posting (i.e. Payment, Denials, Adjustments etc.)
- 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
- 1+ year(s) of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
- Ability to work scheduled shifts from Monday-Friday 07:30 PM to 05:30 AM and to be flexible to accommodate business requirements
- Ability to communicate (oral/written) effectively in English to exchange information with our client.