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Claims Adjudication - Associate Claims

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  • Posted 17 months ago

Job Description

  • Carelon Global Solutions India is seeking a highly creative and meticulous Associate - Claims, who will be responsible for all Processing level delivery performance as per set SLA parameters
  • The incumbent will report to Team Lead - Business operations and must understand the business delivery, present and metrics with leadership; brief and deliver all in-house process delivery requirements, apart from coordinating with onshore partners as and when required

JOB RESPONSIBILITY

Associate - Claims(Business Operations) will be responsible for the following:

  • BS/MS in Computer Science with minimum 1+ years of experience-Experienced/Fresher
  • Familiar with MS Office - basics (Excel/Power point/Outlook - primarily)
  • Very strong Communication Comprehension skills with the ability to evaluate key technical/Calculations needed to deliver basic process delivery
  • Working knowledge on basic technologies around persistence, search, graph and distributed technologies
  • Excellent oral and written communication skills
  • Healthcare domain knowledge - nice to have
  • Flexible to work in any shift in office premises per set organizational/Business requirements

QUALIFICATION

  • Bachelors or Masters degree in fine arts/ design
  • Non-BTech (preferably)

EXPERIENCE

  • 0-2+ years of overall experience including extra-ordinary internal personal skills, communication skills
  • Minimum 1+ yrs experience in role applying for (on rolls)
  • Healthcare / Claims Experience will be added advantage

SKILLS AND COMPETENCIES

  • Responsible for Internal/Onshore calibration; Maintain updates tracker; Upskilling requirements plan upskilling sessions - as needed
  • Manage new hire associates and plan for their training and nesting as needed
  • Excellent Data management - Inventory allocated; status of pended / on hold inventory
  • Should be able to manage and track onshore connects, suggest/drive automation ideas demos and help them develop as needed
  • Conduct team huddle on process updates, internal sample audit, participate in error review/root cause at operations level and provide performance data for group aligned with
  • Agile Solution centric
  • Inclusive
  • Flexible to work in any shifts/Work from office

More Info

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Job ID: 84410455