PA - Claims

Genpact

2 - 5 years

Jaipur

Posted: 29/11/2024

Getting a referral is 5x more effective than applying directly

Job Description

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

About Company

Genpact is a global professional services firm delivering digital transformation by putting digital and data to work to create competitive advantage.