• Working on multiple screens, hand-on with claims processing
• Review and scrutinize claims and process claims into the computer system as per the provided DLPs /guidelines
• Determine accurate claims payment or denial, identify, and elevate dubious claims or system issues to process the claim accurately.
• Process claims in a timely manner, as per the required TAT
• Correct errors or omissions on claim and investigate questionable data
• To maintain Quality as per the SLA
• To maintain Productivity as per the SLA
• Continuously meet and exceed the assigned Targets
• Performance should be maintained in accordance with the process performance parameters
• To maintain confidentiality of work done
• To follow all regulatory requirements and procedures as per the company policy
• Display high levels of professionalism in the work delivered and overall conduct

• Claims Adjudication / Adjustment
• Knows how to review HCFA 1500 and UB04 processing (not mandatory).
• Facets experience is a plus (not mandatory)

Thanks & Regards, 

Harry 
Recruiter 
Reqroute, Inc 
Recruiting solutions for the digital world