Role:-

Ensure the claims settlement in correct status (accepted, pending, rejected) Ensure the financial status of the batch is in correct status (total amounts of accepted,
pending, rejected ones is equal to the total claimed amounts)Identify the rejected amounts with its reasons and classify it into valid and invalid
deductions. Communicate with the payer for the invalid deductions to get approval for resubmission
process for these deducted amounts.Identify the valid deductions and classify it according to the role of each stakeholder in
the operation.Communicate with the stakeholder and process owner with the valid deductions and put
together the proper way to get rid of these mistakes that lead to deductions.Maintain a high level of accuracy and productivity while meeting
established performance metrics and quality standards.Ensure every month that reconciliation with every payer is going on a smooth wayJob RequirementsBachelors degree in pharmacyEx Claims, and Chain Pharmacy experience.2+ Years of experience in a similar fieldGood interpersonal and negotiation skills.Ability to handle stress and work in a fast-paced environment and Flexible working
hours.Detail-oriented and Strong organizational skills to prioritize workload effectively.Ability to work independently and as part of a team and meet tight deadlines.Fluency in English, both written and spokenHave a good communication skillsProficiency in Microsoft Office (Specially Excel) and other relevant software applications.

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