Trainee Medical Reviewer- Dental Claims
Pune
Responsibilities:
Review, analyze, make appropriate and accurate decisions on dental claims in accordance with policy and state/federal law and regulations. Analyze claim detail and apply knowledge of claims procedures, product design, contract provisions and state and federal regulations to make appropriate, accurate, and timely claim decisions.This includes having a knowledge of plan provisions, determination of eligibility, verification of data input, identification of correct benefit level, coordination of benefits, and corrections.
Qualifications:
6 months of non-clinical work experience preferred (in TPA, insurance sector, financial services etc). Dentist by qualification – BDS or MDS degree (internship completed). Ability to maintain a high degree of accuracy and pay strict attention to detail.Must have excellent written and verbal communication skills. Ability to use basic math skills to determine claim payment. Work independently with good time management skills as well as in a team environment. Must have the ability to efficiently navigate and use multiple technology solutions.
Ability to maintain confidentiality. Ability to thrive in a fast-paced, production environment.
Additional Information:
Must Haves:
- Bachelor of Dental Surgery (BDS) – internship completed.
- Minimum 6 months of non-clinical work experience preferred (in TPA, insurance sector, financial services etc).
- Ability to work in night shift during the training time (5:30pm to 2:30AM) and in 1:30pm to 10:30pm in as regular work timings.
- Proficient in MS Office, written and verbal communication skills.
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