Job Family Summary:

Accurate and in-depth analysis of rejection for effective resubmission thereby ensuring maximum revenue with measures to prevent future denials achieved by root cause analysis and implementation of the corrective actions with the help of internal and external stake holders.

Role Summary:

To audit & process all type of rejected claims received by the payers and resubmitting them correctly after thorough investigation and justification.

Primary Responsibilities:

Properly process and audit all type of claims received by the payers, from the medical and insurance perspective.

• Assure meeting the daily assigned target in terms of quantity & quality.
• Report back any type of claims observation or issues that may affect the process.
• Ensure that the medical ethics are respected at all times while performing the medical evaluation of the claims.
• Partici...