Claims Specialist

Job Title : Claims Specialist

Location : Mumbai

About Us

Quantanite is a global outsourcing partner delivering exceptional customer experience and back-office solutions to some of the world's leading brands. We take pride in our fast-paced, inclusive work culture that empowers individuals to perform at their best—wherever they are in the world.

Position Overview

We are seeking a detail-oriented and proactive Claims Specialist to join our team. This role is responsible for reviewing, processing, and following up on insurance claims to ensure timely and accurate reimbursement. You will collaborate closely with internal teams, insurance companies, healthcare providers, and patients to resolve billing discrepancies and maintain compliance with all relevant regulations.

The ideal candidate will have a strong understanding of claims management processes, exceptional organisational skills, and the ability to work effectively in a fast-paced environment.

Key Responsibilities

• Review claims for assigned offices and ensure timely submission.
• Perform quality control checks on patient accounts to verify accurate billing.
• Review and analyse denial queues to identify outstanding claims and unpaid balances.
• Follow up on denied, underpaid, or rejected claims with insurance companies to resolve billing discrepancies and secure correct reimbursement.
• Investigate and resolve claim rejections or denials, including preparing appeals or demands when necessary.
• Collaborate with the Insurance Verification team to confirm eligibility and coverage for patients, ensuring accurate billing information is recorded.
• Communicate with insurance companies, patients, and healthcare providers to obtain additional information needed for claim processing.

Qualifications

What We Offer

Quantanite is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

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Skills Required

Denial Management, Microsoft Office Suite