Bams bhms for Non clinical TPA work claim department Noida up location
Bams bhms for Non clinical TPA work claim department Noida up location
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Job Description
Overview:
Key Responsibilities:
- Review and analyze healthcare claims for accuracy and completeness
- Collaborate with internal teams to ensure timely processing of claims
- Verify medical records and documentation to support claim adjudication
- Communicate with healthcare providers and insurance companies to gather necessary information
- Ensure adherence to TPA guidelines and regulatory requirements
- Conduct research and analysis to support claims decisionmaking
- Assist in handling appeals and disputes related to claims
- Provide support in creating reports and documentation
- Participate in process improvement initiatives to enhance claim processing efficiency
- Handle customer queries and resolve issues related to claims
- Maintain confidentiality and data accuracy in claimrelated tasks
- Stay updated on industry developments and best practices in claims management
- Contribute to team meetings and training sessions
- Support in managing claimrelated correspondence and communications
- Adhere to ethical standards and professional integrity in all claimrelated activities
Required Qualifications:
- Graduate or Postgraduate degree in BAMS/BHMS from a recognized institution
- Prior experience in nonclinical TPA claim processing or healthcare insurance domain
- Knowledge of medical terminology and healthcare coding systems
- Strong understanding of insurance principles and claim adjudication processes
- Excellent analytical and problemsolving skills
- Effective written and verbal communication abilities
- Ability to maintain accuracy and attention to detail in claimrelated tasks
- Proficiency in using claim processing software and tools
- Familiarity with regulatory guidelines and compliance requirements in healthcare claims
- Capability to work collaboratively in a team environment
- Understanding of customer service standards and practices
- Capability to handle high volumes of claims while meeting deadlines
- Knowledge of basic medical billing practices and documentation requirements
- Ability to adapt to changes in claim processing procedures and industry norms
- Certification or training in claims management or healthcare administration (preferred)
regulatory compliance,report creation,customer query resolution,tpa,team collaboration,insurance,analytical thinking,claims management certification/training,medical billing practices knowledge,communication skills,adjudication,claim processing software proficiency,ethical standards adherence,customer,non-clinical,medical records verification,management,adaptability to industry changes,tpa guidelines,industry development knowledge,regulatory guidelines familiarity,medical terminology knowledge,claims decision-making,insurance principles understanding,processing,communication abilities,analytical skills,attention to detail,customer service standards understanding,claims management,healthcare,documentation,healthcare claims review
Employment Type
Full Time
