0 - 1 years
1 Lacs
Posted:None|
Platform:
Work from Office
Full Time
Selected trainees Will be trained on Claim adjudication process
They will evaluate and processes claims in accordance with company policies and procedures per CMS guidelines/SOP
Reviews and analyzes data for in-process claims in order to identify and resolve errors prior to final adjudication
Exercises good judgment and remains knowledgeable in related company policies and procedures
Achieves teamwork, production and quality standards in order to assure timely, efficient and accurate claims processing
Gain knowledge of Commercial, Medicaid, Medicare & TPA claims processing guidelines
Knowledge of medical coding/billing including ICD-10, CPT, CMS-1500, UB-04 etc.
Knowledge of different providers payment methodologies (i.e., capitation, fee for service based on RBRVS, Medicaid and other negotiated flat rates, RVS pricing, Per Diem, DRG pricing, etc.) preferred
Pay or deny per the guidelines/SOP
Maintain confidentiality of all information, policies, and procedures as required by the Health Insurance Portability and Accountability Act (HIPAA) protocols
Flexibility with shift according to client need is mandatory
He/She will report to Team Lead
Fresher with good analytical and communication can attempt for Trainee
Neltner Business Services
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