Claims Processing (Day Shift) - Only Freshers

As a candidate for this position, you should possess experience in U.S. health insurance claim processing and have knowledge of medical billing and coding terminologies. You should be willing to work in both night and day shifts. Your role will involve understanding plan documents and general benefits, demonstrating strong attention to detail and accuracy, and being proficient in Microsoft Word and Excel. Key Responsibilities: - Process claims and ensure accuracy during testing of plan build - Understand and analyze plan documents to determine benefits and coverage - Analyze, review, and adjudicate provider claims - Ensure legal compliance with client policies, procedures, state, and federal regulations during the claim process - Review claims to determine the reasonableness and medical necessity of costs - Verify member eligibility, benefit coverage, and research or apply authorizations - Integrate knowledge as a skilled specialist to solve problems and find new efficient workflows - Keep claims information confidential and maintain HIPPAA compliance - Identify areas of weakness, provide suggestions, and update documentation for process improvement - Perform general administrative duties as assigned Qualifications Required: - 1 year of experience in U.S. Health Insurance - Location: Navi Mumbai, Maharashtra - Availability for both Night Shift and Day Shift - Work Location: In person Please note that this is a full-time position that requires you to be detail-oriented, analytical, and knowledgeable in the field of health insurance claim processing. As a candidate for this position, you should possess experience in U.S. health insurance claim processing and have knowledge of medical billing and coding terminologies. You should be willing to work in both night and day shifts. Your role will involve understanding plan documents and general benefits, demonstrating strong attention to detail and accuracy, and being proficient in Microsoft Word and Excel. Key Responsibilities: - Process claims and ensure accuracy during testing of plan build - Understand and analyze plan documents to determine benefits and coverage - Analyze, review, and adjudicate provider claims - Ensure legal compliance with client policies, procedures, state, and federal regulations during the claim process - Review claims to determine the reasonableness and medical necessity of costs - Verify member eligibility, benefit coverage, and research or apply authorizations - Integrate knowledge as a skilled specialist to solve problems and find new efficient workflows - Keep claims information confidential and maintain HIPPAA compliance - Identify areas of weakness, provide suggestions, and update documentation for process improvement - Perform general administrative duties as assigned Qualifications Required: - 1 year of experience in U.S. Health Insurance - Location: Navi Mumbai, Maharashtra - Availability for both Night Shift and Day Shift - Work Location: In person Please note that this is a full-time position that requires you to be detail-oriented, analytical, and knowledgeable in the field of health insurance claim processing.