Claims Associate
- Optum
- 1 - 3 years
- Hyderabad
- 4 months ago
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Job Description
Primary Responsibilities:
- Claims adjudication/Adjustments/Rework by reviewing the policies, researching, investigating, negotiating, processing, and adjusting claims
- Consistently meet established productivity, schedule adherence and quality standards
- Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so
This is a challenging role that takes an ability to thoroughly review, analyze and research claims to verify pricing, review prior authorizations and process them for payment as per the policies.
You'll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy, which will impact the timely processing of the claims.
Required Qualifications:
- Graduate in any discipline except BTech/MCA
- Proficiency with Windows PC applications, which includes the ability to navigate multiple programs and learn new and complex computer system applications
Preferred Qualifications:
- Freshers/ experience in health care, processing medical, dental, prescription or mental health claims
- Should be flexible to work if any shift
- Work form office
Job Classification
Industry: RetailFunctional Area / Department: BFSI, Investments & TradingRole Category: General InsuranceRole: Insurance AnalystEmployement Type: FreshersContact Details:
Company: OptumLocation(s): Hyderabad
Keyskills: claims adjudication variance analysis pc claims health claims non voice process hipaa health insurance us healthcare vlookup claim payment enrollment claims processing payment posting denial management medical billing
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