Mphasis Recruitment 2025 - knowledge specialist

Mphasis Recruitment 2025

By locating and updating information, offers customer service support to third party administrators, managed care organizations, Health Maintenance Organizations, Preferred Provider Organizations, and many more in the US healthcare insurance market.

Technical Skills:

• A minimum of one to two years' experience in reviewing and handling medical claims is necessary. 
• Experience handling medical claims processing is essential. 
• Experience with enrollment and provider maintenance is necessary. 
• Expertise in using computers.

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Process Skills:

• Examine assertions for veracity and precision. 
• Determine the validity of claims by granting or refusing them based on predetermined standards. 
• Investigates pending claims and follows up with relevant departments to complete the resolution of said claims.
• Maintaining up-to-date knowledge of the client's products, processes, and services 
• Evaluate and handle medical claims in accordance with protocols, meeting predetermined deadlines 
• Keep correct records and notes of all documentation related to claims. 
• Ensure that all quality parameters are fully adhered to. 
• Make sure the schedule is followed exactly. 
• Achieving all established goals, such as quality, productivity, and maintaining the necessary Excel reports.

Behavioral Skills :

• Seek out pertinent data and enter it into the client systems in accordance with established protocols and guidelines.
• Paying close attention to details when completing tasks and meeting daily and weekly targets with the necessary quality within the allotted time frames. 
• Updates pertaining to relevant healthcare data should be promptly entered into the computer system, making sure that it is accurate, comprehensive, and follows departmental protocols. 
• Examine the data for any inconsistencies or errors, and if you can, fix them. 
• Respect the team rules in order to keep the team as a whole cohesive. 
• Capacity to oversee and prioritize tasks. 

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Certification:

• Graduate (Only Arts or Science) / Diploma / Undergraduate (10+2) - Non-Technical Only 
• Accurately typing at 35 to 40 wpm without looking at the keyboard, 95% of the time 
• Good communication skills.