Claims-PD

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. We dream in digital, dare in reality, and reinvent the ways companies work to make an impact far bigger than just our bottom line. We’re harnessing the power of technology and humanity to create meaningful transformation that moves us forward in our pursuit of a world that works better for people. Now, we’re calling upon the thinkers and doers, those with a natural curiosity and a hunger to keep learning, keep growing., People who thrive on fearlessly experimenting, seizing opportunities, and pushing boundaries to turn our vision into reality. And as you help us create a better world, we will help you build your own intellectual firepower. Welcome to the relentless pursuit of better.
We are inviting applications for the role of Process Developer - Claims
In this role, you will be responsible for Data Entry of Information related to personal details, provider details, invoice information, procedure & impairment codes
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