In this Role you will be Responsible For . Review and process insurance claims. . Validate Member, Provider and other 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. . Scrutinizing Medical Claim Documents and settlements. . 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 tea . Resolving complex situations following pre-established guidelines Requirements for this role include: . 0 -1 year of experience in any Healthcare BPO . University degree or equivalent that required 3+ years of formal studies . 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. . Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM (weekend's if required) and to be flexible to accommodate extra hours due to business requirements . Ability to communicate (oral/written) effectively in English to exchange information with our client.
