Audit Support Assistant I

Role & Responsibilities

• Call multiple US healthcare payers/providers to collect and validate required claim information.
• Access client applications and review relevant claim information.
• Audit claims and EOBs to identify incorrect or overpaid claims.
• Perform audits based on client policies, procedures, and SOPs.
• Analyze claims and supporting documents to validate overpayments.
• Collect accurate information and documentation required for claim resolution.
• Maintain clear and accurate documentation of audit findings and outcomes.
• Manage assigned inventory and meet defined productivity, quality, and SLA targets.
• Use available tools and applications to resolve assigned cases.
• Follow process SOPs and stay updated with process changes.
• Implement feedback from managers and quality teams to improve performance.
• Maintain compliance with internal controls and data-security requirements.

Preferred Candidate Profile

• Graduate in any discipline.
• Maximum 4 years of experience in US Healthcare, BPO, Claims, or related processes.
• US Healthcare experience is preferred, especially Payer/Provider Calling or Claims.
• Freshers with excellent communication skills may also be considered.
• Strong verbal and written communication skills.
• Good analytical and problem-solving skills.
• Ability to interpret data and make timely decisions.
• Ability to work independently and handle multiple projects simultaneously.
• Willingness to work in night/US shifts.
• Good attention to detail and ability to follow defined processes and SOPs.