Associate / Senior associate Claims administration

Job Family Summary:

The Operations Department is responsible to manage all aspects of claims management including Onsite operations and back end processing. The department primarily works on main objective of submitting the claims in time with highest quality to ensure the client receives the payment with minimal or no rejections.

Role Summary:

The Associate is involved is receiving the claims from every client either in paper or electronic format. He batches the received claims and segregates them as per insurances. Prepares a statement for reconciliation with the client and queries the client for any missing documents or claims. Scanning of the document is done and batching is done within the billing system

Primary Responsibilities:

Compile, sort and organize paper claims or medical charts to create batches and/or enter into database.

Input text and data from documents into spreadsheets, databases, or electronic files.

Pay attention to detail and input data correctly and accurately.

Crosscheck and verify data keyed into the databases for accuracy.

Correct incorrectly entered data.

Maintain and update workflow record regarding work completed and work pending.

Assist other department staff in transcription of medical data, system entry of coding, scanning and other tasks as necessary

Job Requirements:

• Compile, sort and organize paper claims or medical charts to create batches and/or enter into database.
• Input text and data from documents into spreadsheets, databases, or electronic files.
• Pay attention to detail and input data correctly and accurately.
• Crosscheck and verify data keyed into the databases for accuracy.
• Correct incorrectly entered data.
• Maintain and update workflow record regarding work completed and work pending.
• Assist other department staff in transcription of medical data, system entry of coding, scanning and other tasks as necessary

Key Performance Indicators (KPI's)

• Meeting the set targets for processing the claims
• Maintain the 95% quality for processing claims.