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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.

• Data Entry of Information related to personal details, provider details, invoice information, procedure impairment codes
• Validation of information entered by indexer and from governance stand point, look after Policy Non Policy messages
• Check Select accurate Pre-authorization and 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
• Validating information entered by data Entry Operator
• Interpreting, analyzing further investigating the Policy messages on various tools like support point, info site etc.
• Interpretation of hospital contracts taking actions 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

Minimum qualifications

• Graduate in any stream

• B.Sc. Life Science
• Good knowledge of healthcare medical terminologies
• Should have analytical skills to look into details investigate
• 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. For more information, visit www.genpact.com . Follow us on Twitter, Facebook, LinkedIn, and YouTube.