Adjudication - Claim Examiner

Job Title: Claim Examiner "Adjudication"

Location: Chennai

Job Type: Full-Time

Shift: Day Shift “Based on the Client Requirement”

Gender: Male/ Female

Experience: Fresher to 6 Months "Training Given by the Company".

Desired Candidate Profile

• Responsible for the coordination and resolution of the administrative denials and appeals.

• Ability to understand logic of standard medical coding (i.e., CPT, ICD-10, HCPCS, etc.).

• Ability to resolve claims that require adjustments and adjustment projects, Identify claim(s) with inaccurate data or claims that require review by appropriate team members.

• Meet & Exceed Production, Productivity, and Quality goals

• Process Insurance Claims timely and qualitatively

• Review medical documents, policy documents, policy history, Claims history, and system notes and apply the trained client-level business rules to make appropriate Claims decisions, call out claims trends, and flag fraud activities

Eligible Criteria:

• Any Degree/ Life Science 

Benefits: ESI /PF / GRATUITY / BONUS / LEAVE ENCASH / PAID LEAVE/ INSURANCE

Interview Date: 11-Dec-24 to 10-Jan-2025

SYNTHESIS HEALTHSOFT SERVICES & SOLUTION LLP,

No: 141, Prakash Towers, 2nd Floor, OMR Road, Kottivakkam, Near IGP Factory,

Chennnai- 600041.

Contact Direct HR: + 919176332863

HR Mail ID: hr@synthesis.care, hr@nittanycreative.com