Executive-Back Office-Claims Medical Bill Review
NoidaFull-time20–30 yrsPosted over a month ago
Leadership operations role at EXL in Noida. Needs 20+ years and a diploma.
About the role
Adjudication associate is responsible for timely and accurate payment of Medical Bills submitted by US based hospital and doctors. The process includes claim adjudication, checking compensability, invoice review and the validation of the details in other systems and determine/decide on the accuracy of the amount billed and/or the need for denial of the claim based on result of research.
What you'll do
- Responsible for timely and accurate payment of Medical Bills submitted by US based hospital and doctors
- Ensure that the process transactions are processed as per Desktop procedures
- Ensure that the assigned targets are met in accordance with SLA and Internal standards
- Ensure that the quality of transaction is in compliance with predefined parameters as defined by Process Excellence
- Ensure adherence to established attendance schedules
What you need
- LLMs
- Data analysis
- Financial statements