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Claims Adjudication Associates

Claims Adjudication Associates

Firstsource

1 - 5 years

2 - 4 Lacs

bengaluru

Posted:1 month ago| Platform:

Apply

Skills Required

health care services healthcare bpo us healthcare claims adjudication claims processing medical services medical billing professional services health claims healthcare operations claims healthcare medical hospital facility management

Work Mode

Work from Office

Job Type

Full Time

Job Description

Hiring for

Need immediate joiners only

Job Summary:

Key Responsibilities:

Review, verify, and adjudicate healthcare claims (professional and facility).
Ensure claims are processed accurately as per policy guidelines and benefit coverage.
Analyze medical documentation, invoices, and coding to validate claim submissions.
Identify discrepancies, incomplete information, or potential fraud indicators.
Maintain service-level timelines and quality standards.
Coordinate with internal teams for claim clarifications or escalations.
Document all actions taken during claims review and maintain proper records.

Required Experience & Skills:

Healthcare claims background is mandatory.
Experience in
hospitality (hospital operations)
and
medical claims handling
.
Hands-on experience in
professional (physician) and facility (hospital) claims processing
.
Knowledge of medical terminology, billing, and coding (ICD, CPT, HCPCS preferred).
Strong analytical skills and attention to detail.
Good communication and documentation skills.

Qualifications:

Graduate in any discipline
1-5 years of experience in healthcare claims adjudication.

Interested candidates can reach out to HR Bhanumathi on 8660537090

Disclaimer:

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