Caliber Point (Hexaware) Recruits Freshers For Adjudication - Apply Soon!!!

[VelMurugan]

Adjudication - Executive

Job Description :

Check critical field entry on HCFA-1500, UB-92, Dental, and Superbills claims for eligible claim payment
Check claim eligibility for the patient/insured verifying the Employee records
Check deductible applicability on eligible claim for payment
Apply Co-payment rule sets on applicable claims
Check claims for Pre-existing conditions
Check availability of repricing amounts and route for repricing if necessary
Co-ordinate benefits according to the Explanation of Benefits received from an primary carrier of the patient/insured if applicable
Ensure correct bundling and unbundling of procedures for surgery claims
Should be able to interpret policy document for covered and non-covered services and accordingly ensure correct benefits
Regular follow-up on pended claims to ensure timely payment
To meet procedural, payment and financial quality standards as per SLA's
Should be punctual and adhere to company leave policies
Readiness to work across shifts and across processes
Should adhere to all clauses as per non-disclosure agreement
Should seek job related information from colleagues and peers
Seek feedback from seniors for self development

Desired Profile :
6 Months to 2 Yrs Experience in Claims Processing / Adjudication
Graduate in any discipline (No B.E / B.Tech / MCA / MBA)

Experience : 0 - 3 Years

Education :
UG - Any Graduate - Any Specialization
PG - Post Graduation Not Required

Compensation:    Industry Standards

Location : Chennai

Contact : Pradeepa
Caliber Point Business Solutions

Telephone : 044-66307061

Email : pradeepa.chidambaram@caliberpoint.com

Website : http://www.caliberpoint.com