HealthEdge Rules Payer(HRP) - Associate Claims Carelon Global Solutions India

1.0 - 5.0 years

0 Lacs

hyderabad, telangana

On-site

As an Associate - Claims at Carelon Global Solutions India, you will be part of a dynamic team responsible for processing and adjusting claims submitted by members and providers. Your role will involve conducting research, resolving discrepancies in claims, making informed decisions based on received information, and collaborating with subject matter experts to enhance processes. You will be expected to be flexible in working shifts and locations as per organizational requirements. Your primary responsibilities will include: - Processing and adjusting claims in adherence to set SLA parameters - Conducting research and reaching out to various areas for claim resolution - Identifying and correcting discrepancies in claims - Handling complex scenarios and making accurate decisions based on available information - Collaborating with SMEs to address process gaps and simplify procedures To qualify for this role, you should possess: - A Bachelor's or Master's degree (Non-BTech preferred) - 1 to 4 years of experience in Claims/Adjustment processing in the US Healthcare domain - Knowledge of MS Office tools, strong communication skills, and problem-solving abilities - Familiarity with basic technologies related to persistence, search, graph, and distributed technologies At Carelon, we believe in offering limitless opportunities for growth and development to our associates. Our work environment is designed to foster innovation, creativity, and well-being, providing comprehensive rewards, recognition, and competitive health benefits. We are committed to creating an inclusive culture that celebrates diversity and empowers our employees to deliver their best. If you require reasonable accommodation due to a disability during the application process, please request the Reasonable Accommodation Request Form. Carelon Global Solutions is an equal opportunity employer, dedicated to providing an inclusive and supportive work environment for all employees. Join us at Carelon Global Solutions India and be part of a team that is dedicated to simplifying healthcare operations and improving lives and communities.,

Posted 2 days ago

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The cleaned title is Associate Claims Carelon Global Solutions India

1.0 - 5.0 years

0 Lacs

hyderabad, telangana

On-site

As an Associate - Claims at Carelon Global Solutions India, you will be responsible for all Processing level delivery & performance as per set SLA parameters. Reporting to the Team Lead, Business Operations, you must have a deep understanding of business delivery, metrics, and leadership. Your role will involve briefing and delivering all in-house process requirements, as well as coordinating with onshore partners when necessary. Your responsibilities will include processing/adjusting claims submitted by members/providers, conducting research to resolve claim-related issues, evaluating discrepancies, making decisions based on received information, and collaborating with SME/OE to identify process gaps and simplify procedures. You should be able to handle complex scenarios and different states effectively. To qualify for this role, you should hold a Bachelor's or Master's degree, preferably non-BTech, with a strong knowledge of the healthcare domain. You are required to have a minimum of 1 to 4 years of experience in Claims/Adjustment processing within the US Healthcare sector. You should be familiar with MS Office basics, possess excellent communication and comprehension skills, and be able to evaluate key technical calculations for basic process delivery. Additionally, working knowledge of technologies related to persistence, search, graph, and distributed technologies is desirable. At Carelon, we believe in offering limitless opportunities to our associates, aligning with our brand belief that limitless minds are our most valuable asset. We provide an environment that nurtures growth, well-being, purpose, and a sense of belonging. Our focus on learning and development, innovation, holistic well-being, rewards, and recognition sets us apart as an employer of choice. We are committed to fostering an inclusive culture and providing reasonable accommodations to ensure that every individual can contribute their best. As an Equal Opportunity Employer, we celebrate diversity and offer support to individuals with disabilities through our Reasonable Accommodation Request Form. If you are passionate about making a difference in healthcare operations and possess the required qualifications and skills, we invite you to join our team as a dedicated Associate - Claims at Carelon Global Solutions India.,

Posted 1 week ago

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