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Healthcare & Insurance Operations Associate

India, Chennai · Job Posted March 21, 2026
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Job Description

The Healthcare & Insurance Operations Associate role involves processing adjudication claims, resolving payment denials, and ensuring compliance with healthcare insurance policies. Candidates should have 1-3 years of experience in claims processing, strong analytical and communication skills, and the ability to work independently. This position requires attention to detail and the ability to meet client SLAs.

Job Responsibility

  • Process Adjudication claims and resolve for payment and Denials
  • Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
  • Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations
  • Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
  • Organizing and completing tasks according to assigned priorities
  • Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team
  • Resolving complex situations following pre-established guidelines

Requirements

  • 1-3 years of experience in processing claims adjudication and adjustment process
  • Experience of Facets is an added advantage
  • Experience in professional (HCFA), institutional (UB) claims (optional)
  • Both under graduates and post graduates can apply
  • Good communication (Demonstrate strong reading comprehension and writing skills)
  • Able to work independently, strong analytic skills

Nice to have

  • Experience of Facets
  • Experience in professional (HCFA), institutional (UB) claims

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  • Experience in professional (HCFA), institutional (UB) claims (optional)
  • Both under graduates and post graduates can apply
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  • Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
  • Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations
  • Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
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  • Both under graduates and post graduates can apply
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  • Process Adjudication claims and resolve for payment and Denials
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