OPD CLAIM PROCESSOR at ACKO

Bengaluru, karnataka, India -

Full Time

Start Date

Immediate

Expiry Date

08 Feb, 26

Salary

0.0

Posted On

10 Nov, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Analytical Skills, Communication Skills, Problem-Solving Skills, Attention to Detail, Organizational Skills, Insurance Claims Processing Software, Medical Billing, Coding Systems, ICD-10, CPT

Industry

Description

About Job The Medical Claim Processor is responsible for end-to-end processing of medical insurance claims (reimbursement), ensuring accuracy, compliance with policy terms, and adherence to turnaround time (TAT). This role requires close coordination with hospitals, customers, internal teams, and third-party administrators to deliver timely and efficient claim settlements. The Medical Claim Processor plays a critical role in ACKO by ensuring seamless claim processing, customer satisfaction, and financial stability. They are expected to work efficiently under pressure, manage multiple tasks simultaneously, and maintain high levels of accuracy and productivity. Skills & Qualification Strong analytical skills, with the ability to review and verify claim details for accuracy and compliance. Excellent communication skills, with the ability to effectively collaborate with hospitals, customers, internal teams, and third-party administrators. Ability to work efficiently under pressure, manage multiple tasks simultaneously, and maintain high levels of accuracy and productivity. Proficiency in insurance claims processing software, with the ability to adapt to new systems and technology. Knowledge of medical billing and coding systems, including ICD-10 and CPT. Strong problem-solving skills, with the ability to identify and resolve claim-related issues in a timely and efficient manner. Ability to maintain accurate records and reports, with a strong attention to detail and organizational skills. Responsibilities End-to-end processing of medical insurance claims (reimbursement), ensuring accuracy, compliance with policy terms, and adherence to turnaround time (TAT). Collaborate with hospitals, customers, internal teams, and third-party administrators to deliver timely and efficient claim settlements. Review and verify claim details for accuracy and compliance, identifying and resolving any discrepancies or errors. Manage multiple claim files simultaneously, prioritizing tasks and meeting deadlines to ensure timely claim settlements.

Responsibilities

The Medical Claim Processor is responsible for end-to-end processing of medical insurance claims, ensuring accuracy and compliance with policy terms. They collaborate with various stakeholders to deliver timely and efficient claim settlements.