Senior Representative
Coimbatore, Tamil Nadu, India
Adjudication - Medicare, Medicaid, RHC and Trible•Managed the adjudication of claims for Medicare, Medicaid, Rural Health Centers (RHC), and Tribal healthcare programs.•Analyzed and processed claims to determine eligibility, coverage, and benefits for members, identifying discrepancies and addressing issues related to claims adjudication.•Collaborated with healthcare providers, insurers, and internal teams to resolve complex claims inquiries and ensure timely payment resolution.•Utilized advanced knowledge of healthcare policies, procedures, and coding systems to ensure accurate processing and reduce claim rejections.•Provided exceptional customer service by addressing member and provider inquiries related to benefits, claims status, and policy details.