PA-Claims

Genpact

2 - 5 years

Lucknow

Posted: 9/3/2024

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.

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