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Medical Coordinator - Claim Processing

Medical Coordinator - Claim Processing

MKPIT

1 - 5 years

0 Lacs

pune maharashtra

Posted:1 day ago| Platform: Shine logo

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Skills Required

communication data entry strong communication skills verifying processing insurance claims medical information capture reviewing processing medical insurance claims compliance with insurance policies healthcare regulations working with healthcare providers maintaining accurate records updating patient accounts communicating with providers patients review denied claims initiate appeals follow up on pending claims collaborate with coding billing teams ensure compliance with healthcare regulations insurance guidelines stay updated on policy changes assist in audits generate reports on claim status trends

Work Mode

On-site

Job Type

Full Time

Job Description

As a Medical Coordinator - Claim Processing, your role involves verifying and processing insurance claims, ensuring accuracy in medical information capture, and facilitating communication among insurance companies, healthcare professionals, and patients. Your responsibilities will include: - Reviewing and processing medical insurance claims - Ensuring compliance with insurance policies and healthcare regulations - Working with healthcare providers to gather necessary medical records - Verifying patient and provider information accuracy before claim submission - Data entry into claim processing systems - Maintaining accurate records of claims - Updating patient accounts - Communicating with providers and patients for missing information - Reviewing denied claims - Initiating appeals if needed - Following up on pending claims - Collaborating with coding and billing teams for claim accuracy - Ensuring compliance with healthcare regulations and insurance guidelines - Staying updated on policy changes - Assisting in audits - Generating reports on claim status and trends - Recommending process improvements Ideal candidates for this position will have: - A bachelor's degree in healthcare administration or related fields - Previous experience in medical billing or claim processing - Knowledge of medical terminology - Attention to detail - Strong communication skills - Proficiency in claim processing software for experienced candidates This position is crucial for the efficient processing of medical claims, timely reimbursement for healthcare providers, and accurate fulfillment of patients" financial and insurance requirements. You will be hired initially as an intern with the potential for full-time employment post the probation period. Work Type: Full-time Schedule: - Day shift - Night shift Location: Pune, Maharashtra (Preferred) Work Location: In person,

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Medical Coordinator - Claim Processing