HC & Insurance Operations Senior Rep.
Location
Tennessee | United States
Job description
- Review and process insurance claims.
- Validate Claims information.
- Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
- Coordination of Claim Benefits based on the Policy & Procedure.
- Maintain productivity goals, quality standards and aging timeframes.
- Organizing and completing tasks per assigned priorities.
- Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
- Resolving complex situations following pre-established guidelines
Requirements for this role include:
- University degree or equivalent that required formal studies of the English language and basic Math
- 6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions
- 6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
- 6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
- 6+ months of experience that required prioritizing your workload to meet deadlines
**Required schedule availability for this position is Monday-Friday 6PM/4AM IST The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend’s basis business requirement.
Job tags
Salary