PA-Claims

Genpact

2 - 5 years

Lucknow

Posted: 03/09/2024

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.