HGS is a global provider of technology, AI, and business services that helps organizations transform with confidence. At HGS, we combine technology, AI, and human expertise to deliver Intelligent Experiences that drive growth and transformation. Our strong foundation in CX enables us to create impactful solutions across industries. Through our Realized AI approach, we deliver practical innovation with measurable outcomes. Part of the multi-billion-dollar Hinduja Group, HGS takes a “globally local” approach with 18,000+ employees across 10 countries and 30 delivery centers.”

Position Summary

The Claims Specialist II is responsible for hospital and/or physician billing collections and follow-up. Duties include working with payers to resolve issues and facilitate prompt payment of claims. A solid understanding of patient billing, claims submission, and payer-specific requirements is essential. This role focuses heavily on resolving insurance processing errors and denials across payers such as Medicare, Medicaid, Blue Cross, and commercial health insurance carriers.

Key Responsibilities

• Examine medical claims

• Verify health insurance benefits

• Follow up on claim status

• Identify and resolve issues preventing claim resolution

• Correct and resubmit claims

• Document actions taken

• Maintain expert customer service

• Ensure legal compliance

• Utilize Microsoft Excel effectively

Skills & Qualifications

• Minimum 2 years’ experience in Revenue Cycle Management or 2 years plus Certification in Billing/Coding

• Comprehensive knowledge of insurance plans, member eligibility, and medical billing

• Understanding of CPT, ICD-10, UB, HCFA, and 837 terminologies

• Strong interpersonal and customer service skills

• Detail-oriented with strong problem-solving and research abilities

• Excellent math, verbal, and communication skills

• Computer proficiency, including financial software

• Documentation and data entry expertise

• Ability to meet and exceed productivity goals (portfolio-based)

• Experience evaluated at hiring and reviewed annually based on KPIs and productivity

Work Environment & Conditions

• Normal office environment

• Requires sitting and standing typical of office work

• Manual dexterity for calculator and computer use

• Occasional overtime or shortened hours depending on business needs

HGS is an equal opportunity employer committed to fostering diversity, equity, and inclusion. We do not discriminate based on race, ethnicity, religion, gender, national origin, age, disability, veteran status, genetic information, or any other characteristic protected by applicable law. We believe a diverse workforce drives innovation and helps us better understand and serve our global customers and communities.