Job Description

Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose - the relentless pursuit of a world that works better for people - we serve and transform leading enterprises, including the Fortune Global 500, with our deep business and industry knowledge, digital operations services, and expertise in data, technology, and AI.We are inviting applications for the role of Process associate Claims
To assess claims products to ensure that benefit spend is in accordance with the policies and rules relevant to our members 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

Qualifications we seek in you
Minimum qualifications

• Graduate

Preferred qualifications

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

Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values diversity and inclusion, respect and integrity, customer focus, and innovation. Get to know us at www.genpact.com and on X, Facebook, LinkedIn, and YouTube.
Furthermore, please do note that Genpact does not charge fees to process job applications and applicants are not required to pay to participate in our hiring process in any other way. Examples of such scams include purchasing a 'starter kit,' paying to apply, or purchasing equipment or training.

Genpact