Process Associate

Key Responsibilities:

• Claim Review: Examine and adjudicate medical claims to ensure completeness, accuracy, and compliance with payer policies and regulations.
• Data Verification: Verify patient information, medical services, and provider details to ensure proper billing and coding.
• Issue Resolution: Identify and resolve discrepancies, errors, or issues related to claims processing, including coordinating with healthcare providers and payers as needed.
• Documentation: Maintain accurate records of claim adjudication processes, decisions, and communications.
• Regulatory Compliance: Stay updated on changes in healthcare regulations, payer policies, and billing procedures to ensure compliance.
• Customer Service: Provide exceptional support to internal teams, healthcare providers, and patients regarding claim status and resolution.
• Reporting: Generate and review reports related to claim processing metrics and performance.

Qualifications:

• Experience: 1-2 years of experience in medical billing, coding, or claims adjudication.
• Knowledge: Familiarity with medical billing codes (CPT, ICD-10, HCPCS) and payer guidelines.
• Skills: Strong analytical skills, attention to detail, and problem-solving abilities.
• Communication: Excellent written and verbal communication skills to effectively interact with stakeholders.
• Technical Proficiency: Proficient in medical billing software and MS Office applications.
• Education: Any Degree Preferred with Good Communication and domain Knowledge

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