Process Associate - Claims
- Genpact India
- 2 to 4 Yrs
- Jaipur
- 5 years ago
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Job Description
*With a startup spirit and 90,000+ curious and courageous minds, we have the expertise to go deep with the world s biggest brands and we have fun doing it. Now, we re calling all you rule-breakers and risk-takers who see the world differently, and are bold enough to reinvent it. Come, transform with us.
Are you the one we are looking for
We are inviting applications for the role of PA, ClaimsTo 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.
Responsibilities- Data Entry of Information related to personal details, provider details, invoice information, procedure & impairment codes
- Validation of information entered by indexer and data Entry Operator
- Check & Select correct 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
- Dealing with Policy & Non Policy messages
- Interpreting, analyzing & further investigating the Policy messages on various tools like support point, info site etc.
- Interpretation of hospital contracts & taking appropriate action 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
Minimum qualifications
- Graduate
- B.Sc. Life Science
- Good knowledge of healthcare & medical terminologies
- Eye for detail & investigative skills
- Good interpretation & comprehension skills
Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values diversity and inclusion, respect and integrity, customer focus, and innovation. For more information, visit www.genpact.com. Follow us on Twitter, Facebook, LinkedIn, and YouTube.
,Employement Category:
Employement Type: Full timeIndustry: IT - SoftwareRole Category: IT Operations / EDP / MISFunctional Area: Not ApplicableRole/Responsibilies: Process Associate - ClaimsContact Details:
Company: Genpact IndiaLocation(s): Jaipur
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