Hc and insurance operations associate

Roles and Responsibilities: :Process Adjudication claims and resolve for payment and Denials :Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process :Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co:pay, out of pocket, maximum inside limits and exclusions, state variations :Ensuring accurate and timely completion of transactions to meet or exceed client SLAs :Organizing and completing tasks according to 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: :1:3 years of experience in processing claims adjudication and adjustment process :Experience of Facets is an added advantage. :Experience in professional (HCFA), institutional (UB) claims (optional) :Both under graduates and post graduates can apply :Good communication (Demonstrate strong reading comprehension and writing skills) :Able to work independently, strong analytic skills **Required schedule availability for this position is Monday:Friday 5.30PM/3.30AM IST (AR SHIFT). 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.