Job Description

With a startup spirit and 115,000+ curious and courageous minds, we have the expertise to go deep with the world\xe2\x80\x99s biggest brands\xe2\x80\x94and 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\xe2\x80\x99re 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\xe2\x80\x99re 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 Claims Assessor
To assess claims products to ensure that benefit spend is in accordance with the policies and rules relevant to our members\xe2\x80\x99 policies and contracted agreements with providers of Healthcare.
Responsibilities

• Data Entry of Information related to personal details, provider details, invoice information, procedure & impairment codes
• Validation of information entered by indexer and data Entry Operator
• Check & Select correct 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
• Dealing with Policy & Non Policy messages
• Interpreting, analyzing & further investigating the Policy messages on various tools like support point, info site etc.
• Interpretation of hospital contracts & taking appropriate action basis that
• Referring cases to various department like HCS, TMT, Triage after adjudication as and when required
• Identify any over charge, ineligible chargers, contract compliance, Provider or Member Fraud

• Graduate

• B.Sc. Life Science
• Good knowledge of healthcare & medical terminologies
• Eye for detail & investigative skills
• Good interpretation & comprehension skills