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PwC

Compare

3.4

based on 9.1k Reviews

Video summary

2702 PwC Jobs

Managed Services - BOS - Appeals & Grievances - Specialist - Operate

Pricewaterhouse Coopers Private Limited

3.4

based on 9.1k Reviews

1-5 years

₹ 3.3 - 5L/yr (AmbitionBox estimate)

Hyderabad / Secunderabad

1 vacancy

Managed Services - BOS - Appeals & Grievances - Specialist - Operate

PwC

posted 4hr ago

Job Role Insights

Flexible timing

Key skills for the job

Medical Coding Data Analysis Consulting Medical Billing Auditing Microsoft Power BI

+ 3 more

Job Description

Insurance FollowUp Contact insurance companies via phone, email, or online portals to follow up on outstanding claims. Identify and resolve issues causing payment delays, such as claim denials or underpayments. Verify claim status, appeal denied claims and resubmit claims when necessary.

Documentation and Reporting Maintain accurate and detailed documentation of all communications and actions taken. Update account information and billing systems with payment details and followup notes. Generate reports on accounts receivable status, aging trends, and collection efforts.

Compliance and Regulations Adhere to HIPAA regulations and guidelines to ensure patient confidentiality and data security. Stay informed about insurance policies, billing guidelines, and Medicare policies.

Team Collaboration Collaborate with internal departments, to work on the Medicare appeals and grievance requests.

Medicare & Medicaid Appeals & Grievances
Member appeals, Grievances, Dismissal, PreService Appeals, Post Services Appeals. member complaints, provider payment appeals, provider payment disputes
Knowledge on the CMS and Hospital & Physicians Billing
HIPAA

Required Knowledge and Skills

Proven experience (1+ years) in US healthcare Payer side.
Strong understanding of Medicare /medical billing processes, insurance claims, and reimbursement methodologies
Excellent communication skills with the ability to effectively interact with insurance companies, patients, and internal stakeholders.
Attention to detail and ability to prioritize tasks to meet deadlines.
Knowledge of medical coding (ICD10, CPT) is a plus.
Experience Level 0 to 1 years.
Shift timings Flexible to work in night shifts (US Time zone)
Preferred Qualification Bachelor s degree / Any Graduate

Employment Type: Full Time, Permanent

Read full job description

PwC Interview Questions & Tips

Prepare for PwC Specialist roles with real interview advice

What people at PwC are saying

3.7

Rating based on 78 Specialist reviews

Anonymous · Engineering - Software & QA in Nagpur

Likes

Thankful Thursday

Dislikes

No work life balance too much work pressure no job security

Skill development - Poor

+5 more

Read 78 Specialist reviews

Specialist salary at PwC

reported by 778 employees

₹1 L/yr - ₹8 L/yr

48% less than the average Specialist Salary in India

View more details

What PwC employees are saying about work life

based on 9.1k employees

75%

88%

58%

88%

Flexible timing

Monday to Friday

No travel

Day Shift

View more insights

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PwC Hyderabad / Secunderabad Office Location

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Hyderabad / Secunderabad (1)

Hyderabad Office

Plot no. 77/A, 8-624/A/1,3rd Floor,Road No. 10,Banjara Hills,Hyderabad Hyderabad
500 034