Executive

EXL; Dadri; On-site; INR 350,000 - 500,000; Full time

Job summary

A leading healthcare data processing firm is seeking a qualified individual to manage data adjustment requests in accordance with US healthcare regulations. The ideal candidate will have a Bachelor's degree and 1-2 years of experience in healthcare terminology. Strong analytical skills and attention to detail are crucial for success in this role. This position offers opportunities for process improvement within a dynamic environment.

Qualifications

• Bachelor's degree or equivalent experience in healthcare, insurance, or related field.
• 1-2 years of experience with US healthcare terminology, CPT/ICD codes, and payer guidelines.
• Strong attention to detail and ability to work under deadlines.

Responsibilities

• Review and process data adjustment requests according to client guidelines.
• Validate details, identify discrepancies, and apply adjustments.
• Ensure compliance with HIPAA and other regulations.

Skills

Analytical skills

Problem-solving skills

Communication skills

Attention to detail

MS Office proficiency

Knowledge of US healthcare terminology

Education

Bachelor's degree in healthcare or related field

Tools

Claims processing systems

Job description

Key Responsibilities:

• Review and process data adjustment requests in accordance with client guidelines and US healthcare regulations.
• Validate details, identify discrepancies, and apply appropriate adjustments.
• Ensure compliance with HIPAA and other regulatory requirements.
• Communicate effectively with internal teams to resolve claim-related issues.
• Maintain accurate documentation and update systems with adjustment details.
• Meet daily/weekly productivity and quality targets.
• Identify process improvement opportunities and escalation of complex cases as needed.

Required Skills Qualifications:

• Bachelor s degree or equivalent experience in healthcare, insurance, or related field.
• 1-2 years of strong understanding of US healthcare terminology, CPT/ICD codes, and payer guidelines.
• Excellent analytical and problem-solving skills.
• Proficiency in MS Office and claims processing systems.
• Strong attention to detail and ability to work under deadlines.
• Good communication skills (written and verbal).