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Process Associate - Claims

Keywords / Skills : Process Associate, Process developer, Process executive, Customer support, Data Entry, Claims

1 - 5 years
Posted: 2019-09-22

Customer Service/Call Centre/BPO
Process/ Work Flow Analyst
Posted On
22nd Sep 2019
Job Ref code
Job Description
Job Description :

With a startup spirit and 80,000+ curious and courageous minds, we have the expertise to go deep with the world\u2019s biggest brands\u2014and we have fun doing it. Now, we\u2019re calling all you rule-breakers and risk-takers who see the world differently and are bold enough to reinvent it. Come, transform with us.
Inviting applications for the role of Process Associate - Claims

In this role, you will be responsible of Data Entry of Information related to personal details, provider details, invoice information, procedure & impairment codes
Validation of information entered by indexer
Check & Select correct Preauthorization
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
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 Front End Savings by investigating claims to Identify any over charge, ineligible chargers, contract compliance, Provider or Member Fraud

Minimum qualifications

Graduate (Preferably B. Com. or B.Sc. Life Science)
Freshers are eligible

Preferred qualifications
Good knowledge of healthcare & medical terminologies
Eye for detail & investigative skills
Good interpretation & comprehension skills
Relevant experience

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
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About Company

Genpact India
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