ZTEKIN SERVICES PRIVATE LIMITED

Compensation

Full Description

Job Summary: Each associate is responsible for validating members’ Out-of-Pocket Maximum (OOPM) cost shares based on the audit years provided in the Accumulator Overages Report. The process involves reviewing the members’ responsibilities according to their plan benefits and ensuring that OOPM limits and any overages are accurate, following the preset criteria established by Centene. If a member has exceeded their OOPM limit, the excess amount will be reimbursed directly through medical claims and pharmacy reimbursements. • 1-3 Years of experience in claims processing • Good logical thinking ability • Knowledge of US Healthcare Industry • Should have exposure to MS Office • 5+ years of team management for a claims process for the lead RESPONSIBILITY: • Adjudication/Adjustments of claims with zero errors • Completion of claims in queue within specified time frame Job Type: Contract Pay: $12.00 - $14.00 per hour Experience: • Healthcare IT: 2 years (Required) • Medicare: 2 years (Required) Work Location: Remote