Senior Claims Associate

Optum Global Solutions India Private Limited
Experience : 2 to 3 Years
Location : Noida
Job Role : Others
Posted on 14 Jan 20
Job is expired
Job DescriptionLast Date 13 Mar 20
Senior Claims Associate

Noida / Gurgaon (836409)

Primary Responsibilities:

  • Accurate processing and completion of medical claims 
  • Process claims that route out of automatic adjudication, within current turnaround standards
  • Proficiency in product lines applicable to processing unit 
  • Understand and apply plan concepts to include: Deductible, Coinsurance, Co-pay, State variations 
  • Recognize issues related to variable deductible, coordination of benefits, carve-out and alternate benefits 
  • Recognize potential pre-existing conditions, misstatements and fraudulent claims 
  • Process correspondence and requests for reconsideration within time service standards 
  • Use pre-approved electronic letters as well as handwritten letters to communicate with customers, providers, attorneys, regulators and other external entities 
  • Adhere to quality improvement initiatives 
  • Demonstrate increasing productivity to meet minimum requirements while maintaining quality standards 
  • Special projects as required

Required Qualifications:

  • College Graduate
  • 2-3 years of customer service experience analyzing and solving customer problems
  • Minimum 1 year of experience in Medical Billing (Payment posting/AR Calling/Charge Entry/Denial management/Cash posting)
  • Experience working in the healthcare industry
  • Experience working with claims and/or recovery
  • Proficiency with computer and Windows PC applications 
Job Type : Full Time
Interview Type : Face to Face Interview
Company Description
The Optum Ireland, part of the UnitedHealth Group family of businesses, Automation Centre of Excellence is an exciting new venture that’s passionate about process automation. We support the organization through the delivery of automation solutions, using existing, new and emerging technologies to enhance savings, improve productivity and quality and reduce cost.
Job is expired
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