Senior Associate

Job Description
We are seeking an experienced  Senior Associate - Claims ,Appeals & Grievances  to join our  US Healthcare Payer Operations  team in Chennai. The ideal candidate will have strong expertise in  member and provider appeals ,  grievance resolution , and  CMS-compliant determinations  and ensure adherence to regulatory timelines and quality standards.

Key Responsibilities
End-to-end  claims adjudication, appeals & grievances (added advantage) processing (Payer Side)
Review and resolve  member and provider appeals
Issue  CMS-compliant determinations  for Medicare & Medicaid
Coordinate with  UM, Medical Review, Claims, and Provider Relations
Ensure  TAT/SLA adherence  and maintain case documentation

Required Skills & Experience
1-4 years  in  US healthcare payer operations
Strong experience in  claims adjudication, appeals & grievances (Payer Side) added advantage.
Knowledge of  Medicare, Medicaid, CMS, HIPAA, NCQA
Experience in  Member or provider appeals
Good communication skills; able to handle  escalations independently

Job Location:

Firstsource Solutions Ltd.  5th Floor, ETA Techno Park, Block 4, OMR, Navallur, Chennai, 603103.  Landmark:  Near Vivira Mall
Shift Details
Night Shift
Must be flexible to work in any shift/timing

Cab Facility
One-way drop cab provided
Up to 30 km (doorstep service)

If interested, kindly share your updated CV with dee

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Disclaimer:  Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or the  email address.