Sr. Claims Adjudicator(Facets)

Advenxa; Ernakulam; On-site; INR 450,000 - 600,000; Full time

Job summary

Advenxa is seeking an Sr. Claims Adjudicator (Facets) at Infopark, Kochi, Kerala. The role requires 2+ years of experience and a degree of any field. You will adjudicate US healthcare claims, verify eligibility and benefits, and ensure compliance with payer guidelines.

Candidates with FACETS experience have an added advantage. The position operates in the evening shift and requires high attention to detail and strong analytical skills.

Qualifications

• Strong understanding of US healthcare insurance and claims lifecycle.
• Knowledge of eligibility, benefits, claims payment, denials and adjustments.
• FACETS experience is a strong advantage.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and accuracy.

Responsibilities

• Review and adjudicate US healthcare claims accurately and efficiently.
• Verify member eligibility, benefits, coverage and claim information.
• Analyze claims to determine payment, denial or adjustment.
• Review claims against benefit plans, provider contracts and payer guidelines.
• Identify and resolve claim discrepancies and processing errors.
• Handle claim adjustments, reprocessing and corrections as required.

Skills

Analytical skills

Attention to detail

Problem solving

Strong communication

Education

Any Degree

Tools

FACETS

Job description

Sr. Claims Adjudicator (Facets)

Location: Infopark, Kochi,Kerala

Qualification: Any Degree

Experience: 2+ Years

Salary: 4.5 LPA- 6 LPA

FACETS Experience: Preferred / Added Advantage

Shift: 6:00 PM 3:00 AM

Requirements

• Strong understanding of US healthcare insurance and claims lifecycle.
• Good knowledge of eligibility, benefits, claims payment, denials, and adjustments.
• Experience with FACETS is a strong advantage.
• Strong analytical and problem-solving skills.
• Excellent attention to detail and accuracy.

Responsibilities

• Review and adjudicate US healthcare claims accurately and efficiently.
• Verify member eligibility, benefits, coverage, and claim information.
• Analyze claims to determine appropriate payment, denial, or adjustment.
• Review and validate claims against benefit plans, provider contracts, and payer guidelines.
• Identify and resolve claim discrepancies, exceptions, and processing errors.
• Handle claim adjustments, reprocessing, and corrections as required.