Key Responsibilities:- Review and process data adjustment requests in accordance with client guidelines and US healthcare regulations.
- Validate details, identify discrepancies, and apply appropriate adjustments.
- Ensure compliance with HIPAA and other regulatory requirements.
- Communicate effectively with internal teams to resolve claim-related issues.
- Maintain accurate documentation and update systems with adjustment details.
- Meet daily/weekly productivity and quality targets.
- Identify process improvement opportunities and escalate complex cases as needed.
Required Skills & Qualifications:- Bachelor's degree or equivalent experience in healthcare, insurance, or related field.
- 1–2 years of strong understanding of US healthcare terminology, CPT/ICD codes, and payer guidelines.
- Excellent analytical and problem-solving skills.
- Proficiency in MS Office and claims processing systems.
- Strong attention to detail and ability to work under deadlines.
- Good communication skills (written and verbal).
