Claims Executive For a Leading Healthcare in Chennai

Prodigy Recruitment Consultants

5 years

2 - 6 Lacs

chennai

Posted:1 day ago| Platform:

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Skills Required

insurance claims tpa medical insurance claims processing claim processing tpa insurance claims tpa executive insurance recovery claims management tpa coordination claims handling health claims tpa insurance recovery claim settlement insurance cases health insurance

Work Mode

Work from Office

Job Type

Full Time

Job Description

Role & responsibilities

Short Paid Claim Contesting Executive-Drive timely and accurate contesting of short-paid claims across hospital-insurer interfaces, ensuring recovery yield and SOP compliance.

Analyze short-paid claims and categorize by deduction type, insurer, and RCA triggers.
Draft and submit contest letters with supporting documentation via IHX and insurer portals.
Track contesting outcomes and escalate unresolved cases per SLA timelines.
Collaborate with unit credit cells and central recovery team for RCA discipline and documentation hygiene.
Maintain dashboards for contesting status, win-loss ratios, and financial impact.
Ensure adherence to SOPs and flag deviation trends for governance review.

Preferred candidate profile

Strong understanding of hospital billing, claim adjudication, and insurer deduction patterns.
Proficiency in Excel, IHX, and insurer portals.
Attention to detail and documentation accuracy.
Ability to work cross-functionally and manage follow-ups with urgency.
14 years in hospital revenue cycle, claims processing, or insurer coordination.

If interested please share your profile to yuvaraju@prodigyrecruit.com or call 9884286090

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