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| Job Location | Pune |
| Education | Not Mentioned |
| Salary | 300000 - 700000 INR |
| Industry | Medical Transcription |
| Functional Area | Others |
| EmploymentType | Full-time |
Hiring for Medicare Enrolment Location: Pune Notice : Only Immediate Looking for min 1 year for SPE into Medicare enrolment CTC : 5 LPA Min 5 Years for SME into Medicare enrolment CTC : 7 LPAResponsibilities Maintaining accurate member records. Entering system eligibility and enrollment data on a daily basis including new enrollees, change in circumstances terminations, PCP and broker Informations. Research EDI 834 files (Medicare, Medicaid, Medicare Advantages, IFP, On and Off Exchange) Provider Data maintenance, reaching out onshore team queries, Conducting error sessions. Maintain productivity, quality for self/team and maintain confidentiality. SOP reviews, Gap determinations, Task assignments, Training, Productions Reports, Team handling. Remain Informed of developments in areas of expertise by attending calls, update sharing, teams queries. Handling provider appeals, complaints, Pre authorization, Denials management, Utilization management reviews with help, support and coordinating medical directors and RN. Collect and organize track information from various sources, generate acknowledgement and resolutions letters with regulatory standards refers to appeals RN as necessary. Utilize multiple internal and externals application and program to meet established productivity and standards. Reviewing documents from various sources. (HRBA, EDI, MAILBOX, SPIDAR IMAGES, RCM) Tickets, error codes resolving, Pend process, DCN process, Claims process, Key employe enrollments. Train new joiners, process learners, RCM process, maintain process performance parameter. Enrolling member for different plans. (HMO, PPO, DHMO, NPOS) and benefits (MEDICAL, DENTAL, VISION, HSA, FSA, GTL, LTD, STD, LIFE and COBRA) demographic info updating, PCP assigning, SSN, MSO, PID merge as per request received. Interested candidates contact HR Contact No:- +91-7090082451Email ID: [Confidential Information]
Keyskills :
medicare