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Claims Analyst

1.00 to 4.00 Years   Bangalore   09 Dec, 2021
Careernet
Job LocationBangalore
EducationNot Mentioned
SalaryRs 3.0 - 6 Lakh/Yr
IndustryIT - Software
Functional AreaSales / BD,General / Other Software
EmploymentTypeFull-time

Job Description

Job SummaryClaims Analysts are responsible for analyzing, auditing, and investigating their assigned clients Accounts Receivable (A/R) process in order to ensure quality, resolve errors, and provide strategic solutions. Generally, supports a single GRS platform and specialty.Essential Duties & Responsibilities

  • Develop a solid understanding of assigned clients process in order to strategically review and analyze their A/R functions
  • Conduct regular audits of Medical Billing Specialist claim work for accuracy and quality; manages clean claim ratios for assigned clients
  • Provide direction to Client Leads on claim audit corrections and resolution
  • Prepare and analyze reports of audit reviews and performance issues with a focus on identifying trends, instituting continuous quality improvement initiatives, and identifying and providing on-going training opportunities for specialists
  • Provide second-tier review on advanced and escalated claim issues to a satisfactory resolution
  • Resolves outsource vendor s escalates claims and claim rework
  • Log all client issues encountered in internal tracking system, including enhancement requests, bugs, errors, and inquiries. Make management aware of any client issues or problems
  • Modifies process and procedures to prevent claim rework through automation ideas
  • Participate in continuing education of applicable software and hardware
ExperienceEducation
  • A high school diploma/GED required
  • Bachelor s degree preferred but not required
Minimum Qualifications
  • Quality control auditing and analysis experience preferred
  • Medical billing knowledge and Healthcare experience preferred
Skills/Knowledge
  • Strong analytical skills; ability to conduct research, creatively solve problems, and deal with ambiguity
  • Highly developed verbal and written communication skills
  • Able to read, analyze, and interpret complex documents
  • Independent, logical, strategic thinker with high focus and attention to detail
  • Effective written and verbal communication and presentation style
  • Proficient compute skills including Microsoft Office, Word, and Excel
  • Excellent interpersonal skills and able to work with a variety of personality types
  • Excellent organizational skills; ability to multitask, set priorities, and meet deadlines
  • Strong customer services skills and a high level of professionalism
Work Environment/Physical Demands
  • While at work, this position is primarily a sedentary job and requires that the associate can work in an environment where they will consistently be seated for the majority of the work day
  • This role requires that one can sit and regularly type on a key board the majority of their work day
  • This position requires the ability to observe a computer screen for long periods of time to observe their own and others work, as well as, in-coming and out-going communications via the computer and/or mobile devices
  • The role necessitates the ability to listen and speak clearly to customers and other associates
  • The work environment is an open room with other associates and noise from others will be part of the regular workday
,

Keyskills :
customer relationsinsurancequalityslaauditingwave soldermedical billingmicrosoft officeanalytical skillsidentifying trendsaccounts receivablequality improvementinterpersonal skillsverbal communicationcontinuing educationwritten communicatio

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