Job Description
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
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
Role: Back Office - Other
Industry Type: IT Services & Consulting
Department: Customer Success, Service & Operations
Employment Type: Full Time, Permanent
Role Category: Back Office
Education
UG: Any Graduate
PG: Any Postgraduate
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
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
Role: Back Office - Other
Industry Type: IT Services & Consulting
Department: Customer Success, Service & Operations
Employment Type: Full Time, Permanent
Role Category: Back Office
Education
UG: Any Graduate
PG: Any Postgraduate
💡 Quick Summary
Seeking a career-building opportunity? The PA | Claims position is now open for candidates interested in the Fresher Jobs sector. This role in Jaipur offers a professional environment and growth potential.
Requirement Snapshot: Candidates should possess basic communication skills, a proactive attitude, and the ability to work in a team. Experience in Fresher Jobs is a plus.