Executive

EXL

1 - 3 years

0 Lacs

noida uttar pradesh india

Posted:16 hours ago| Platform: Foundit logo

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Skills Required

claims processing systems us healthcare terminology payer guidelines icd codes

Work Mode

On-site

Job Type

Full Time

Job Description

Key Responsibilities:- Review and process data adjustment requests in accordance with client guidelines and US healthcare regulations.

Validate details, identify discrepancies, and apply appropriate adjustments.
Ensure compliance with HIPAA and other regulatory requirements.
Communicate effectively with internal teams to resolve claim-related issues.
Maintain accurate documentation and update systems with adjustment details.
Meet daily/weekly productivity and quality targets.
Identify process improvement opportunities and escalate complex cases as needed.

Required Skills & Qualifications:- Bachelor's degree or equivalent experience in healthcare, insurance, or related field.

12 years of strong understanding of US healthcare terminology, CPT/ICD codes, and payer guidelines.
Excellent analytical and problem-solving skills.
Proficiency in MS Office and claims processing systems.
Strong attention to detail and ability to work under deadlines.
Good communication skills (written and verbal).

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