Company Name 1
Hinduja Global Solutions
Job Title
Healthcare Associate
Job Description
Handled high volumes of inbound and outbound calls, ensuring prompt and professional communication with providers.
Conducted insurance verification for dental plans, ensuring accuracy and compliance with policy requirements.
Reviewed and confirmed dental eligibility and benefits for patients to facilitate seamless service delivery.
Processed insurance claims with precision, resolving discrepancies and ensuring timely submission to maximize reimbursements.
Managed email communications, addressing inquiries, providing updates, and maintaining organized documentation.
Job Title
Medical Claim Examiner
Job Description
Investigated and researched claims to verify members' eligibility, benefits coverage, and required authorizations, ensuring accuracy and compliance with healthcare policies.
Reviewed, evaluated, and processed various types of claims, including Encounter Data, Professional and Institutional Claims, Provider Organization (PPO), and Medi-Cal claims.
Ensured claims payment and denial accuracy, adhering to compliance standards and turnaround time requirements.
Maintained up-to-date knowledge of healthcare regulations and claims processing procedures to ensure consistent service excellence.
Collaborated with team members and providers to address discrepancies and resolve complex claim issues promptly and efficiently.