Genpact Process Associate – Claims B.Sc. Life Science
Responsibilities
Data Entry of Information related to personal details,
provider details, invoice information, procedure & impairment codes
Validation of information entered by indexer
Check & Select correct Preauthorization
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
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
Minimum qualifications
Graduate
Preferred qualifications
B.Sc. Life Science
Good knowledge of healthcare & medical terminologies
Eye for detail & investigative skills
Good interpretation & comprehension skills
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