Claims Executive
Hexaware Technologies
Thane, Navi Mumbai, Mumbai (All Areas)0–5 yrs6h agovia Naukri
Role: Claims Executive
Key Responsibilities
- Review incoming healthcare claims for accuracy and completeness, ensuring 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.