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Join our team as an Insurance Operations Associate and play a key role in processing insurance claims, analyzing medical and policy documents, and ensuring quality outcomes. If you have strong customer service skills, attention to detail, and experience in claims processing, this is your opportunity to grow in a dynamic, team-oriented environment.
Job Responsibility:
Process Insurance Claims timely and qualitatively
Meet & Exceed Production, Productivity and Quality goals
Review medical documents, policy documents, policy history, Claims history, system notes and apply the trained client level business rules to make appropriate Claims decisions, call out claims trends and flag fraud activities
Stay up to date on new policies, processes, and procedures impacting the outcome of Claims processing
Be a team player and work seamlessly with other team members on meeting customer goals
Requirements:
Both Under Graduates and Post Graduates can apply
Excellent communication (verbal and written) and customer service skills
Able to work independently
strong analytic skills
Detail-oriented
ability to organize and multi-task
Ability to make decisions
Required computer skills: must have experience with data entry and word processing, possess a working knowledge of MS Office applications, and understand how to navigate through web-based applications
Demonstrate strong reading comprehension and writing skills
Cognitive Skills include language, basic math skills, reasoning ability and verbal communication skills
Ability to work in a team environment
Handling different Reports - IGO/NIGO and Production/Quality
To be in a position to handle training for new hires
Work together with the team to come up with process improvements
Strictly monitor the performance of all team members and ensure to report in case of any defaulters
Encourage the team to exceed their assigned targets
Required schedule availability for this position is Monday-Friday 6PM/4AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend’s basis business requirement
Candidate should be flexible & support team during crisis period
Should be confident, highly committed and result oriented
Experience on working in an office environment set up utilizing Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
Experience in a professional/office related role that required you to communicate (oral/written) effectively with internal team members and external customers
Experience in a role that required a focus on quality including attention to detail, accuracy, and accountability for your work product
Candidate should be flexible to work from home and office environment. Broadband connection is must while working from home
Nice to have:
3+ years of experience processing insurance claims in the health, life, or disability disciplines that required knowledge of CPT, HCPCS, ICD9/10, CDT
2+ year(s) of experience in role that required understanding and interpreting complex documents such as medical records and legal contracts