Job Title: Provider Support (Inbound Voice Process)
Department: Operations
Employment Type: Full-Time
Reports To: Team Manager
Company: Integrum Outsource Solutions Private Limited
Work Shift: Night Shift
Eligibility: Only Male Candidates (Boundaries: Thane to Panvel)
Job Summary:
We are seeking a skilled and experienced Provider Support (Associate/Specialist/Executive) for our Inbound Voice Process. The role involves providing eligibility, benefits, and claim status support via calls, ensuring high-quality service, and adhering to compliance standards.
Key Responsibilities:
- Analyze, review, and adjudicate provider claims.
- Resolve medical claims by approving or denying documentation, calculating benefit amounts, and initiating payments/denials.
- Ensure compliance with company policies, state and federal regulations, and client guidelines.
- Review claims to verify cost reasonability and medical necessity.
- Identify and report overpayments, underpayments, and other discrepancies.
- Communicate with reinsurance brokers for claim processing information.
- Verify member eligibility, benefit coverage, and authorization requirements.
- Utilize domain knowledge to solve problems and improve workflows.
- Maintain HIPAA compliance and protect confidential claim information.
- Provide process improvement suggestions and update documentation accordingly.
- Perform administrative duties as assigned.
Required Qualifications:
Experience & Skills -
- Freshers with excellent communication skills with interest = in Medical Billing (RCM), International Calling, Claim Processing, or Denial Management (A.R) can apply.
- Typing speed of at least 30 WPM.
- Effective verbal and written communication skills.
- Active listening and ability to assess customer needs.
- Critical thinking and problem-solving skills.
Work Environment & Benefits:
- Work from Office - Seawoods Darave, Navi Mumbai
- Drop Facility Available
- Competitive Salary - Rs. 20,000 to Rs. 25,000
Compliance & Adherence:
- Must comply with all company policies and procedures.
- Adherence to HIPAA regulations and healthcare compliance standards.
If you meet the requirements and are looking for a challenging role in the healthcare industry, we invite you to apply and become part of our growing team!
Job Type: Full-time
Pay: ₹20,000.00 - ₹25,000.00 per month
Schedule:
- Night shift
Language:
- English (Required)
Location:
- Navi Mumbai, Maharashtra (Required)
Shift availability:
- Night Shift (Required)
Work Location: In person