5.0 - 10.0 years

3 - 5 Lacs

pune

Work from Office

Key Responsibilities: Review and audit healthcare claims for accuracy, completeness, and compliance with payer policies. Identify and resolve discrepancies, errors, and inconsistencies in claims adjudication. Ensure adherence to HIPAA and other regulatory requirements. Work with internal teams to improve claims processing accuracy. Generate reports and document audit findings. Provide feedback and training to claims processing teams. Required Skills & Qualifications: Bachelor's degree or equivalent experience in healthcare or related fields. Must have: Facet tool experience. Experience in claims adjudication, auditing, or US healthcare payer operations. Strong analytical skills and attention...

Posted 1 month ago

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Presales Consultant Citiustech

10.0 - 15.0 years

17 - 30 Lacs

pune, chennai, mumbai (all areas)

Hybrid

10-15 years experience in any one or more sub-sectors of Healthcare such as Payers i.e. Health Insurance preferably in the US market as Healthcare Consultant. • More than 5 years hands-on experience on TriZetto’s platforms (either Facets or QNXT) – in a PM/BA/TA/Config capacity • Navigate complexities and ambiguities with client ask or industry trend to clearly document & present CitiusTech solution & expertise • Ability to understand the client Problem statement and strong analytical skills for identifying the possible solution • Ability to build professional relationships, a spirit of co-operation, and a flexible approach to work are required • Self-motivated and strong team player • Abili...

Posted 2 months ago

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