Manual Claims Adjudication (Insurance & Life Science) – APAC Region

Review and adjudicate medical insurance claims in line with policy guidelines

Validate member eligibility, coverage, and completeness of claims

Interpret CPT, ICD10, and HCPCS codes to make accurate claim decisions

Analyze clinical documents such as prescriptions, medical reports, and discharge summaries

Identify errors or discrepancies and process claims within defined TAT

Ensure compliance with quality standards and maintain data confidentiality (HIPAA)

Coordinate with internal teams for claim clarifications and resolutions

Support continuous improvement in claims adjudication processes