Sr Associate - Core Claims ( Blended/Hybrid )

Job Description

Job Responsibilities Scrutinizing dental claim documents & settlements Process claims as per the set healthcare guidelines Follow HIPAA guidelines Accurate processing of Dental claims and meeting productivity targets Good understanding of Claims adjudication fundamentals Good understanding of ICT & CPT Codes Knowledge of policy concepts like Deductible, coinsurance, copay, out of pocket Able to learn, adapt, implement process guideline into practice, work as a natural team-player in the process Handle escalations Need to ensure quality and productivity targets are met Ensure compliance with internal policies and procedures, external regulations and information Technical Skills/other skills Computer navigation skills Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy) Working knowledge of MS Excel and MS Word. Process Specific Skills Knowledge of Insurance principles in relation to the US Insurance industry Knowledge about US Culture Knowledge of Dental claims terminologies and processes will be an added advantage Strong organizational skills Good communication skills Demonstrate ability to work independently and in a team environment Self-disciplined and results oriented Ability to multi task Strong understanding and comprehension of the English language Good PC skills Attention to detail Team player Positive attitude