Fresher Graduate - Back Office Executive

Hexaware Technologies; Navi Mumbai; On-site; INR 180,000 - 240,000; Full time

Job summary

Hexaware Technologies in Navi Mumbai is seeking a fresher to join our healthcare claims processing team. The role requires night shift work and is based at our Navi Mumbai location.

You will review claims for accuracy, analyze eligibility, and collaborate with internal teams to resolve discrepancies. Ongoing training will be provided to ensure adherence to regulations and payer policies.

Qualifications

• Fresher candidates only.
• Navi Mumbai location and night shift work.

Responsibilities

• Review incoming healthcare claims for accuracy and completeness, ensuring all necessary information is provided for adjudication.
• Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial.
• Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information.
• Utilize claims processing systems and software to enter, update, and retrieve claims information accurately.
• Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse.
• Ensure timely processing of claims to meet internal and external deadlines, maintaining high levels of productivity and accuracy.
• Collaborate with team members to improve claims adjudication processes and contribute to departmental goals.
• Maintain up-to-date knowledge of healthcare regulations, payer policies, and industry best practices through ongoing training and development.

Job description

Role & responsibilities

• Review incoming healthcare claims for accuracy and completeness, ensuring all necessary information is provided for adjudication.
• Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial.
• Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information.
• Utilize claims processing systems and software to enter, update, and retrieve claims information accurately.
• Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse.
• Ensure timely processing of claims to meet internal and external deadlines, maintaining high levels of productivity and accuracy.
• Collaborate with team members to improve claims adjudication processes and contribute to departmental goals.
• Maintain up-to-date knowledge of healthcare regulations, payer policies, and industry best practices through ongoing training and development.

Fresher only

Navi Mumbai location

Night shift