Remote Claims Examiner: Adjudication & SLA Focus

Firstsource; United States; Remote; USD 42,000 - 62,000; Full time

Job summary

Firstsource Solutions Limited is seeking a remote Claims Examiner to analyze documents and adjudicate claims in line with client specifications. You will determine pay/deny decisions and route items for any missing information, ensuring adherence to TAT and SLA while coordinating with appropriate departments, providers, or members.

The role requires strong communication and comprehension skills to accurately process claims in a remote work environment.

Qualifications

• Analyses documents and adjudicates claims against client specifications.
• Routes claims for missing information to appropriate parties.
• Ensures timely completion per TAT and SLA.

Responsibilities

• Perform claims analysis and decide pay or deny decisions.
• Route claims to correct department or provider/member for required information.
• Meet turnaround time (TAT) and quality SLAs.

Skills

Good Communication Skills

Listening & Comprehension

Job description

Firstsource Solutions Limited is seeking a remote Claims Examiner to analyze documents and adjudicate claims in line with client specifications. You will determine pay/deny decisions and route items for any missing information, ensuring adherence to TAT and SLA while coordinating with appropriate departments, providers, or members.

The role requires strong communication and comprehension skills to accurately process claims in a remote work environment.