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TL-Claims HC

5 - 7 years

0 Lacs

kochi kerala india

Posted:11 hours ago| Platform: Linkedin logo

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Skills Required

efficiency healthcare compliance automation analyze data training support documentation processing reports management resolve development strategies regulations analysis drive

Work Mode

On-site

Job Type

Full Time

Job Description

Job Summary

We are seeking a dedicated professional for the role of TL-Claims HC with 5 to 7 years of experience. The candidate will be responsible for overseeing claims adjudication processes ensuring accuracy and efficiency. This hybrid role requires expertise in MS Office and UiPath with a strong understanding of payer and provider domains. The position involves night shifts offering an opportunity to contribute to our mission of enhancing healthcare services.

Responsibilities

  • Oversee the claims adjudication process to ensure accuracy and compliance with industry standards.
  • Implement and optimize automation solutions using UiPath to streamline claims processing.
  • Collaborate with cross-functional teams to enhance the efficiency of claims management.
  • Analyze claims data to identify trends and areas for improvement in the adjudication process.
  • Provide training and support to team members on best practices in claims adjudication.
  • Develop and maintain documentation for claims processing procedures and automation workflows.
  • Ensure adherence to payer and provider guidelines to maintain compliance and quality standards.
  • Utilize MS Office tools to generate reports and presentations for management review.
  • Monitor and evaluate the performance of claims processing systems to identify potential enhancements.
  • Coordinate with IT teams to resolve technical issues related to claims processing systems.
  • Engage with stakeholders to gather feedback and implement process improvements.
  • Support the development of strategies to reduce claim processing times and improve customer satisfaction.
  • Maintain up-to-date knowledge of industry regulations and trends to ensure compliance.

Qualifications

  • Demonstrate proficiency in MS Office applications for data analysis and reporting.
  • Exhibit expertise in UiPath for developing and managing automation solutions.
  • Possess in-depth knowledge of claims adjudication processes and best practices.
  • Showcase experience in the payer and provider domains to ensure effective claims management.
  • Display strong analytical skills to identify and address process inefficiencies.
  • Communicate effectively with team members and stakeholders to drive process improvements.

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