Adjudication Associate

Synthesis Healthcare Services LLP

Chennai, Tamil Nadu, India

Adjudication Experienced
• Having 0- 1years experience in claim processing.
• Ability to resolve claims that require adjustments and adjustment projects, Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
• Meet & Exceed Production, Productivity, and Quality goals
• Process Insurance Claims timely and qualitatively
• Review medical documents, policy documents, policy history, Claims history, and system notes and apply the trained client-level business rules to make appropriate Claims decisions, call out claims trends, and flag fraud activities.
• Having good exposure to CMS processing guidelines.
• Good Analytical skills.
• Good communication skills.
• Working knowledge of MS office tools.
• Willing to work in any shift.
• Responsible for the coordination and resolution of the administrative denials and appeals.
• Ability to understand logic of standard medical coding (i.e., CPT, ICD-10, HCPCS, etc.).
• Ability to resolve claims that... More Detail

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