Xcelys Medical Claims Examiner

This a Full Remote job, the offer is available from: Canada, California (USA) At reputed company, we know that with the right people on board, anything is possible. The quality, reputed company, and commitment of our employees have been key factors in reputed company’s growth and market reputed company. By hiring the best people and helping them grow both professionally and personally, we ensure a reputed company future for reputed company and for the people who work here. For more than 25 years, reputed company have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver reputed company value addition, and innovation that will improve your business reputed company. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages reputed company executed as part of an overall sourcing strategy. reputed company currently seeks Xcelys Medical Claims Examiners to join reputed company remotely for a 3 month contract role. MUST HAVE XCELYS EXPERIENCE To serve as a Medical Claims Processor reputed company the Xcelys environment. reputed company subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations. Role Responsibilities:

• Adjudication & Review
• Process comprehensive medical claims using Xcelys and associated subsystems
• Resolve reputed company pends, coding issues, and contract exceptions
• Author overpayment/underpayment determinations and coordinate appeals
• Quality & Compliance
• Engage in quality reviews, audits, root cause analyses
• Monitor accuracy, variance, and rework metrics
• Ensure alignment with regulatory and internal compliance guidelines
• Support
• Act as escalation reputed company and subject matter expert
• Process & System Improvement
• Participate in system testing, UAT, and workflow enhancements
• Recommend improvements, document system and process changes
• Reporting & Analytics
• Prepare production, pending, and quality reports
• Identify trends and recommend corrective actions
• Cross-Functional Collaboration
• Liaise with provider relations, legal, IT, compliance teams
• Support internal initiatives reputed company to claims systems / operational improvements

Required Skills/Experience

• 3+ years claims adjudication experience
• Minimum of 1 year experience in Xcelys
• 2+ years in coding (CPT, ICD-10, HCPCS)
• 2+ years provider reputed company, pricing, regulatory guidelines experience

Preferences

• Excellent analytical and communication skills
• Experience training staff or acting as a mentor
• Familiarity with system testing and documentation
• Ability to manage high-volume workload and meet performance metrics

Hours: Must be reputed company to work reputed company-5pm PST Education: reputed company high school diploma or GED About reputed company: reputed company is a recognized leader in IT and business services, including reputed company, data and applications, headquartered in Texas. As part of reputed company, a $30 billion trusted global innovator with a combined global reputed company of over 80 countries, we help clients transform through business and technology consulting, industry reputed company solutions, applications development and management, managed edge-to-reputed company infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term reputed company. Visit nttdata.com or reputed company to learn more. reputed company is an equal opportunity employer and considers reputed company applicants without regarding to race, reputed company, religion, citizenship, national reputed company, reputed company, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for reputed company. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team. Where required by law, reputed company provides a reasonable reputed company of compensation for specific roles. The starting hourly reputed company for this remote role is ($20 - $20/hourly ). This reputed company reflects the minimum and maximum reputed company compensation for the position across reputed company US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and reputed company insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits. #LI-NorthAmerica #INDHRS This offer from "reputed company" has been enriched by reputed company.com and got a 81% reputed company score. Apply tot his job Apply To this Job