Bpo Hc & Insurance Operations Senior Associate

In this Role you will be Responsible ForReview & Processes Healthcare payer claims including HCFA & UB forms.Validate Member, Provider and other Claims information.Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.Coordination of Claim Benefits based on the Policy & Procedure.Maintain productivity goals, quality standards and aging timeframes.Scrutinizing Medical Claim Documents and settlements.Organizing and completing tasks per assigned priorities.Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the teaResolving complex situations following pre-established guidelinesRequirements for this role include:University degree or equivalent that required formal studies of the English language and basic Math3+ Year of experience where you had to apply business rules to varying fact situations and make appropriate decisions3+ Year of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.3+ Year of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.3+ Year of experience that required prioritizing your workload to meet deadlines