PE-Claims HC
This is an office-based, night shift role for a Claims Adjudication Specialist in the healthcare domain. You will process and evaluate claims efficiently to ensure timely adjudication, accuracy, and compliance with company policies and regulatory requirements. Key responsibilities include collaborating with team members to address discrepancies and improve processes, maintaining detailed records of all claims processed, and identifying potential issues with proposed solutions. You will provide insights and feedback to enhance claims adjudication strategies and contribute to continuous improvement of claims processing systems. Strong knowledge of the payer domain is advantageous. A certification such as CPHQ or equivalent in claims adjudication is required. The role demands excellent written and spoken English communication skills and the ability to adapt to a fast-paced environment.
