OPD CLAIM PROCESSOR

About Job

Skills & Qualification

• Strong analytical skills, with the ability to review and verify claim details for accuracy and compliance.
• Excellent communication skills, with the ability to effectively collaborate with hospitals, customers, internal teams, and third-party administrators.
• Ability to work efficiently under pressure, manage multiple tasks simultaneously, and maintain high levels of accuracy and productivity.
• Proficiency in insurance claims processing software, with the ability to adapt to new systems and technology.
• Knowledge of medical billing and coding systems, including ICD-10 and CPT.
• Strong problem-solving skills, with the ability to identify and resolve claim-related issues in a timely and efficient manner.
• Ability to maintain accurate records and reports, with a strong attention to detail and organizational skills.
  

Responsibilities

• End-to-end processing of medical insurance claims (reimbursement), ensuring accuracy, compliance with policy terms, and adherence to turnaround time (TAT).
• Collaborate with hospitals, customers, internal teams, and third-party administrators to deliver timely and efficient claim settlements.
• Review and verify claim details for accuracy and compliance, identifying and resolving any discrepancies or errors.
• Manage multiple claim files simultaneously, prioritizing tasks and meeting deadlines to ensure timely claim settlements.