HealthEdge Rules Payer(HRP) - Associate Claims

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.,