Back Office Executive
Hexaware Technologies
Thane, Navi Mumbai, Mumbai (All Areas)Fresher7h agovia Naukri
About the Role
This is a Back Office Executive position at Hexaware Technologies, designed for freshers.
Key Responsibilities
- Review incoming healthcare claims for accuracy and completeness.
- Ensure all necessary information is provided for adjudication.
- Analyze claims data against payer policies and industry regulations to determine eligibility for payment or denial.
- Communicate effectively with healthcare providers, policyholders, and internal teams to resolve discrepancies or gather additional information.
- Utilize claims processing systems and software to enter, update, and retrieve claims information accurately.
- Identify and report any trends or patterns in claims submissions that may indicate potential fraud or abuse.
- Ensure timely processing of claims to meet internal and external deadlines, maintaining high levels of productivity and accuracy.
- Collaborate with team members to improve claims adjudication processes and contribute to departmental goals.
- Maintain up-to-date knowledge of healthcare regulations, payer policies, and industry best practices through ongoing training and development.
Qualifications
- No specific qualifications listed beyond the role being for a fresher.
Tech Stack
- Claims processing systems
- Software