Process Associate - Claim Assessor @ Genpact India

Job Description

• To assess claims products to ensure that benefit spend is in accordance with the policies and rules relevant to our members policies and contracted agreements with providers of Healthcare.

• Data Entry of Information related to personal details, provider details, invoice information, procedure & impairment codes
• Validation of information entered by indexer and from governance stand point, look after Policy & Non Policy messages
• Check & Select accurate Pre-authorization and 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
• Validating information entered by data Entry Operator
• Interpreting, analyzing & further investigating the Policy messages on various tools like support point, info site etc.
• Interpretation of hospital contracts & taking actions basis that
• Referring cases to various department like HCS, TMT, Triage after adjudication as and when required
• Identify any over charge, ineligible chargers, contract compliance, Provider or Member Fraud

• Graduate in any stream

• B.Sc. Life Science
• Good knowledge of healthcare & medical terminologies
• Should have analytical skills to look into details & investigate
• Good interpretation & comprehension skills

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Rs 0 - 50K PM Rs 50K - 1 LPA Rs 1.0 - 1.5 LPA Rs 1.5 - 2.0 LPA Rs 2.0 - 2.5 LPA Rs 2.5 - 3.0 LPA Rs 3.0 - 3.5 LPA Rs 3.5 - 4.0 LPA Rs 4.0 - 4.5 LPA Rs 4.5 - 5.0 LPA Rs 5 - 6 LPA Rs 6 - 7 LPA Rs 7 - 8 LPA Rs 8 - 9 LPA Rs 9 - 10 LPA Rs 10 - 12 LPA Rs 12 - 14 LPA Rs 14 - 16 LPA Rs 16 - 18 LPA Rs 18 - 20 LPA Rs 20 - 22 LPA Rs 22 - 24 LPA Rs 24 - 26 LPA Rs 26 - 28 LPA Rs 28 - 30 LPA Rs 30 - 32 LPA Rs 32 - 34 LPA Rs 34 - 36 LPA Rs 36 - 38 LPA Rs 38 - 40 LPA Rs 40 - 42 LPA Rs 42 - 44 LPA Rs 44 - 46 LPA Rs 46 - 48 LPA Rs 48 - 50 LPA Rs 50 - 75 LPA Rs 75 Lakh - 1C PA Rs 1 Crore+ PA

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