Are you ready to take your career to the next level? Mphasis is looking for individuals passionate about delivering exceptional customer service support in the healthcare insurance sector. If you have experience in healthcare claims processing and a commitment to excellence, They want to meet you!
Mphasis Hiring! Walk-In Drive in Pune 31st August 2024
Job Title: Knowledge Specialist (Band 5, Level 2)
Reports To: Unit Manager / Asst Unit Manager
Walk in drive, Date: 31st August 2024
Job Description
As a Knowledge Specialist, you will provide top-notch customer service support for third-party administrators, Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), managed care organizations, and more in the U.S. healthcare insurance market. Your primary responsibility will be to identify and update information to ensure exceptional service standards and maintain high customer satisfaction.
Key Responsibilities
- Review healthcare claims for accuracy and legitimacy.
- Adjudicate claims by approving or denying them according to established guidelines.
- Investigate pending claims and coordinate with departments to resolve them.
- Stay updated on products, processes, and services offered by the client.
- Process medical claims within established turnaround times while maintaining accuracy.
- Maintain accurate documentation and ensure full adherence to quality standards.
- Meet all defined productivity and quality targets and manage reports in Excel.
Required Skills and Experience
Technical Skills
- 1-2 years of experience in examining and processing healthcare claims.
- Strong experience in medical claims processing.
- Familiarity with provider maintenance and enrollment processes.
- Proficient with computers and typing speed of 35 to 40 wpm with 95% accuracy.
Process Skills
- Attention to detail and ability to meet targets with required quality.
- Knowledge of healthcare data entry and the ability to correct data errors.
- Ability to prioritize workload and manage time effectively.
- Must be willing to work night shifts.
Behavioral Skills
- Ability to adhere to team norms and contribute to a cohesive work environment.
- Strong communication skills and the ability to manage tasks efficiently.
Certification Requirements
- Undergraduate (10+2), Diploma, or Graduate (Only Arts or Science – Non-Technical).
Important Note
Candidates should arrive in formal attire and bring
- 2 copies of their resume
- Aadhar card
- Educational documents
- Previous or current employment documents
Recruiter: Join us to be part of a dynamic team committed to delivering excellence in healthcare insurance services!
