HR Executive at StarSecutech Pvt Ltd
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Telecalling Role - Customer Service - Healthcare (1-3 yrs)
Primary Responsibilities :
- Accurate processing and completion of medical claims
- Process claims that route out of automatic adjudication, within current turnaround standards
- Proficiency in product lines applicable to processing unit
- Understand and apply plan concepts to include: Deductible, Coinsurance, Co-pay, State variations
- Recognize issues related to variable deductible, coordination of benefits, carve-out and alternate benefits
- Recognize potential pre-existing conditions, misstatements and fraudulent claims
- Process correspondence and requests for reconsideration within time service standards
- Use pre-approved electronic letters as well as handwritten letters to communicate with customers, providers, attorneys, regulators and other external entities
- Adhere to quality improvement initiatives
- Demonstrate increasing productivity to meet minimum requirements while maintaining quality standards
- Special projects as required
Required Qualifications :
- College Graduate
- 0-1 year of customer service experience analyzing and solving customer problems
- Minimum 1 year of experience in Medical Billing (Payment posting/AR Calling/Charge Entry/Denial management/Cash posting,CMS 1500,RCM)
- Experience working in the healthcare industry
- Experience working with claims and/or recovery
- Proficiency with computer and Windows 8 applications
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