Overview
Claims Specialist Jobs in United States at Hexaware Technologies
Title: Claims Specialist
Company: Hexaware Technologies
Location: United States
This will be full time remote role.
Designation: Claims Specialist
Location: US (Remote)
Education: Mandatory: Any Graduate or Equivalent in the US. (BSC/BCOM/BA)
Job Description:
Position Objective: As Service Delivery Executive the incumbent responsibility will be to process the claims (Claims Payment) and ensure that claims processed in a timely and according to the group/plan validation and also meet the client’s SLA in terms of TAT & Quality.
Essential Duties & Responsibilities:
- Reviewing healthcare claims and verifying submitted documents
- Ensuring compliance with adjudication policies and guidelines
- Identifying and flagging incomplete or incorrect claims
- Processing claims based on eligibility and policy terms
- Approving or rejecting claims as per defined authority levels
- Consulting with team leaders or subject matter experts for complex cases
- Informing stakeholders about claim decisions and outcomes
- Preparing and submitting adjudication performance reports
Experience
- 0 to 6 Months organization’s work experience preferred
Technical Competencies: (Job related)
- Computer Savvy
- Should have working knowledge of MS-Office
Soft Skills: (Job related)
- Average English Communication
- Commitment to achieving deadlines
- Ability to make sound judgment and be decisive
- Learning Attitude
- Others