Process Associate - Healthcare Claims
Genpact
Jaipur, India
3d ago

Responsibilities

  • Validation of information entered by indexer
  • Check & Select accurate Pre-authorization
  • Identify duplicate Claims and take appropriate action
  • Reading & taking appropriate action on Alerts related to Members & providers.
  • Referring case to calling team for further information
  • Looking after Policy & Non-Policy messages
  • Interpreting, analyzing & further investigating the Policy messages on various tools like support point, info site etc.
  • Referring cases to various department like HCS, TMT, Triage after adjudication as and when required
  • Identify Front End Savings by investigating claims to Identify any over charge, ineligible chargers, contract compliance, Provider or Member Fraud
  • Qualifications we seek in you

    Minimum qualifications

  • Any Graduate except technical
  • Freshers are eligible
  • Preferred qualifications

  • Good knowledge of healthcare & medical terminologies
  • Eye for detail & investigative skills
  • Good interpretation & comprehension skills
  • Proven experience
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