Knowledge Specialist Job in Chennai at Mphasis

Mphasis is hiring for the role of Knowledge Specialist!

Responsibilities of the Candidate:

• Review claims for legitimacy and accuracy.
• Adjudicate claims by approving or denying them according to established guidelines.
• Investigate pending claims and follow up with respective departments to finalize claims resolution.
• Staying current with knowledge of products/processes & services offered by the client.
• Review and process medical claims according to guidelines within established turnaround time frames.
• Maintain accurate records/notes of claims-related documentation.
• Ensure full adherence to all the quality parameters.
• Ensure 100% adherence to schedule.
• Meet all defined targets like productivity, quality, and maintenance of required reports in Excel.
• Look up relevant information and update (type into) the client systems as per set procedures and policies.
• Enter updates relating to pertinent healthcare data into the computer system promptly ensuring accuracy, completeness, and adherence to department procedures.
• Review data for deficiencies or errors, and correct any incompatibilities if possible.

Requirements:

• Minimum 1 - 2 years experience in examining and processing Healthcare claims required. 
• Medical claims processing experience is a must. 
• Provider Maintenance and enrollment experience are required.
• Proficiency with computers.
• Attention to detail while accomplishing tasks, meeting Weekly/Daily targets with required quality in the given timelines.
• Adhere to the team norms to make the overall team a cohesive one.
• Ability to prioritize and manage workload.
• Must be ready to work in night shifts.    
• Certification: Undergraduate (10+2)/Diploma/Graduate (Only Arts or Science) – Non-Technical Only    
• Typing speed 35 to 40 wpm with 95% accuracy (without looking at the keyboard)
• Good communication skills.