Sr. Associate OPD Claims

ACKO Technology & Services Private Limited; Bengaluru; On-site; INR 350,000 - 500,000; Full time

Job summary

ACKO Technology & Services Private Limited in Bengaluru is seeking a Medical Claim Processor to manage end-to-end processing of medical insurance claims, ensuring accuracy, policy compliance, and adherence to turnaround times.

You will coordinate with hospitals, customers, internal teams, and TPAs to deliver timely claim settlements, review claim details for discrepancies, and maintain precise records with strong attention to detail and productivity under pressure.

Qualifications

• Review and verify claim details for accuracy and compliance.
• Collaborate with hospitals, customers, internal teams, and TPAs.
• Handle multiple tasks and maintain high accuracy under pressure.
• Proficiency in insurance claims software and adapting to new systems.
• Knowledge of ICD-10 and CPT coding for medical claims.
• Strong problem-solving to resolve claim-related issues promptly.
• Maintain accurate records and reports with strong attention to detail.

Responsibilities

• End-to-end processing of medical insurance claims (reimbursement) with accuracy and TAT adherence.
• Collaborate with hospitals, customers, internal teams, and TPAs to ensure timely settlements.
• Review and verify claim details for accuracy, resolving discrepancies or errors.
• Manage multiple claim files simultaneously, prioritizing tasks and meeting deadlines.

Skills

Analytical skills

Excellent communication

Work under pressure

Claims processing software

Medical billing & coding (ICD-10, CPT)

Problem solving

Record keeping & reporting

Tools

Insurance claims software

Job description

About Job

The Medical Claim Processor is responsible for end-to-end processing of medical insurance claims (reimbursement), ensuring accuracy, compliance with policy terms, and adherence to turnaround time (TAT). This role requires close coordination with hospitals, customers, internal teams, and third-party administrators to deliver timely and efficient claim settlements.

The Medical Claim Processor plays a critical role in ACKO by ensuring seamless claim processing, customer satisfaction, and financial stability. They are expected to work efficiently under pressure, manage multiple tasks simultaneously, and maintain high levels of accuracy and productivity.

Skills & Qualification

• Strong analytical skills, with the ability to review and verify claim details for accuracy and compliance.

• Excellent communication skills, with the ability to effectively collaborate with hospitals, customers, internal teams, and third-party administrators.

• Ability to work efficiently under pressure, manage multiple tasks simultaneously, and maintain high levels of accuracy and productivity.

• Proficiency in insurance claims processing software, with the ability to adapt to new systems and technology.

• Knowledge of medical billing and coding systems, including ICD-10 and CPT.

• Strong problem-solving skills, with the ability to identify and resolve claim-related issues in a timely and efficient manner.

• Ability to maintain accurate records and reports, with a strong attention to detail and organizational skills.

Responsibilities

• End-to-end processing of medical insurance claims (reimbursement), ensuring accuracy, compliance with policy terms, and adherence to turnaround time (TAT).

• Collaborate with hospitals, customers, internal teams, and third-party administrators to deliver timely and efficient claim settlements.

• Review and verify claim details for accuracy and compliance, identifying and resolving any discrepancies or errors.

• Manage multiple claim files simultaneously, prioritizing tasks and meeting deadlines to ensure timely claim settlements.