Onsite Industrial Lubricants Sales Representative at Solenis
Solenis
Develop customer relationships and field sales for Solenis and NCH industrial lubrication solutions. The role covers Vicenza, Udine, and Modena, Italy.
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HealthEdge अपने HealthRules Solutions Suite के माध्यम से स्वास्थ्य सेवा भुगतानकर्ताओं के लिए तकनीक विकसित करता है। कंपनी का प्लेटफ़ॉर्म पोर्टफोलियो डिजिटल क्लेम प्रशासन, देखभाल प्रबंधन कार्यप्रवाह और भुगतान की शुद्धता सुनिश्चित करने जैसी सुविधाएँ प्रदान करता है। इससे स्वास्थ्य योजनाओं को परिचालन डेटा को जोड़ने, महत्वपूर्ण प्रक्रियाओं को स्वचालित करने, भुगतान की सटीकता बढ़ाने और सदस्यों के बेहतर अनुभवों का समर्थन करने में मदद मिलती है। स्वास्थ्य सेवा और स्वास्थ्य बीमा पर केंद्रित HealthEdge, सॉफ्टवेयर और परामर्श विशेषज्ञता को एक साथ लाकर भुगतानकर्ता संगठनों को अधिक कुशलता से काम करने और देखभाल का बेहतर समन्वय करने में सहायता करता है।
Remote Claims Examiner II — HealthEdge
Adjudicate healthcare claims for HealthEdge’s health insurance operations platform, reviewing coding, coverage criteria, and payment edits. The role also includes mentoring junior colleagues and contributing to quality and process projects.
विवरण
- Apply established policies and procedures to adjudicate healthcare claims.
- Assess claim system data to determine service appropriateness and whether benefit coverage criteria are met.
- Review adjudication edits and decide whether to pay claims or individual line items.
- Process assigned claims using client guidelines or directions from the team lead.
- Meet productivity goals and financial and procedural accuracy standards.
- Mentor junior team members.
- Support projects such as process documentation, training, quality audits, client surge work, and other assigned activities.
- Raise issues and concerns with management, and take steps to maintain processing accuracy and quality.
- Contribute to projects involving provider data, authorizations, enrollment, and related activities.
आवश्यकताएँ
- High school diploma required.
- One to three years of healthcare claims processing experience.
- Sound understanding of claim data and ability to analyze it.
- Knowledge of physician and hospital practices, coding, billing, and medical terminology.
- Knowledge of CPT, HCPCS, ICD-10, UB-04, CMS-1500, and authorizations.
- ICD-10, CPT, and HCPCS coding experience is a plus.
- Willingness to learn new skills.
- Collaborative approach to teamwork.
- Strong work ethic.
- Ability to adapt quickly in a fast-paced environment.
- Self-motivated and quick to learn.
- Ability to work collaboratively as part of a team.
- May be required to complete a criminal background check before employment.
लाभ
- Full-time, permanent employment.
- Remote work environment.
- Travel may be required based on company needs.
- Reasonable accommodations are available for individuals with disabilities.
- Equal opportunity employer committed to workforce diversity.
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