Chennai Tamil Nadu Process specialist Jobs – 790 Open Jobs Today

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Lead I - AML KYC
UST —Chennai, Tamil Nadu
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Viventium Software —Chennai, Tamil Nadu
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- Full-time
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6d

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Associate II - BPM

UST -
Chennai, Tamil Nadu

Quick apply

Job details

Qualifications

Pricing
Call center experience
Analysis skills
Bachelor's degree
PPM tools
CPT coding
Communication skills

Full job description

Role description

Job Title : Provider Inquiry Specialist

Location : Trivandrum / Chennai / Kochi (India)

Shift : US Shift 5:30pm to 2:30am (Night Shift) - 5 days a week (Work from Office)

Education: Graduate (Any discipline)

Experience: 3-5 years in US Healthcare operations Experience in Provider Inquiry / Provider Support / Claims / Call Center Back Office preferred

Role Summary

The Provider Inquiry Specialist is responsible for reviewing, investigating, and resolving inquiries raised by healthcare providers related to claims, eligibility, benefits, authorizations, and payment details. The role requires strong analytical skills, attention to detail, and clear written communication to ensure accurate and timely provider responses while meeting SLA and quality standards.

Key Responsibilities

Review and investigate provider inquiries received through ticketing or portal based systems (e.g., PEAR / OneHub).
Analyze inquiries related to:
- Claim status and payment
- Eligibility and benefits
- Authorization status
- Denials and adjustments
Provide clear, accurate, and business friendly responses to providers with appropriate explanations.
Research claim details using payer systems and supporting tools to identify the correct resolution path.
Route inquiries to the appropriate internal queues or teams when corrections, adjustments, or further investigation are required.
Document all actions and responses accurately in the case management or tracking system.
Ensure compliance with SLA, TAT, and quality benchmarks for Provider Inquiry processes.
Support backlog and aging clearance by prioritizing work based on turnaround requirements.
Participate in quality feedback sessions, calibrations, and cross audits to reduce repeat errors.
Adhere to HIPAA guidelines and organizational compliance standards at all times.

Tools & Systems (Exposure Preferred)

PEAR Portal / PPM
OneHub / Pulse or similar ticketing systems
Claims processing systems (payer side)
Aerial / CFI / Burgess / HealthRule (or equivalent payer tools)

Required Skills & Competencies

Strong understanding of US Healthcare claims and provider support workflows
Good analytical and problem solving skills
Strong written communication skills (provider friendly and clear explanations)
Ability to handle high volume, repetitive tasks with accuracy
Attention to detail and documentation discipline
Ability to work in a fast changing environment with shifting priorities

Preferred Skills

Prior experience in Provider Inquiry / Provider Support / PEAR inquiries
Experience handling claim denials, pricing, eligibility, and authorization inquiries
Knowledge of US healthcare terminology (EOB, CPT, ICD, authorization, deductible, copay, etc.)

Key Performance Indicators

SLA & TAT adherence
Quality accuracy %
Provider response accuracy and clarity
Backlog & aging management

As part of UST, candidates are expected to demonstrate:

Humility: Respectful collaboration and openness to feedback

Humanity: Empathy towards members, providers, and colleagues
Integrity: Ethical processing and strict adherence to compliance
Customer Focus: Delivering high-quality outcomes aligned with client expectations
Excellence: Continuous improvement and ownership of results

Skills

claims management,healthcare claims,us healthcare,hipaa,onehub,

About UST
UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world’s best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients’ organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact—touching billions of lives in the process.

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process specialist jobs in chennai tamil nadu

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