Innova ESI
Innova ESI delivers innovative engineering and technology solutions, offering consulting, design, and implementation services across multiple industries.
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Role : Business Analyst (Claims Adjudication) (2 Yrs to 15 Yrs) Location : Hyderabad Domain and Business analysis Skills • Healthcare, Dental, Medicare, Medicaid, or Commercial Claims Processing. • Claims lifecycle management. • Claims adjudication rules and payment methodologies. • Provider contracts and fee schedules. • Benefits, eligibility, COB, and authorization processes. • Medical coding (ICD-10, CPT, HCPCS) and/or Dental Coding (CDT Codes) • Requirement Gathering • Process Mapping • Gap Analysis / Root Cause Analysis • UAT Planning and Execution • Preferred knowledge different claims processing platforms
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