HC & Insurance Operations Associate

As a Claims Processor, your role involves processing insurance claims in a timely and qualitative manner. You will be responsible for meeting and exceeding production, productivity, and quality goals. This includes reviewing medical documents, policy documents, claims history, and system notes to make appropriate claims decisions, identify claims trends, and flag fraud activities. It is crucial to stay updated on new policies and procedures affecting claims processing and collaborate effectively with team members to achieve customer goals. Key Responsibilities: - Process insurance claims accurately and efficiently - Review and analyze various documents to make informed claims decisions - Identify and report claims trends and potential fraud activities - Stay informed about new policies and procedures impacting claims processing - Collaborate with team members to meet customer goals Qualifications Required: - Both Under Graduates and Post Graduates are eligible to apply - Excellent verbal and written communication skills - Ability to work independently with strong analytical skills - Detail-oriented with the ability to organize and multitask effectively - Proficiency in data entry, word processing, MS Office applications, and web-based applications - Strong reading comprehension and writing skills - Cognitive skills including language, math, reasoning, and verbal communication - Experience working in an office environment utilizing Windows PC applications - Ability to communicate effectively with internal team members and external customers In addition, as part of the role, you may need to handle different reports such as IGO/NIGO and Production/Quality, provide training to new hires, collaborate with the team on process improvements, monitor team performance, and encourage exceeding assigned targets. The required schedule availability for this position is Monday to Friday from 6 PM to 4 AM IST, with the possibility of overtime and weekend work based on business requirements. Furthermore, as a candidate for this role, you should be flexible and supportive during crisis periods, confident, highly committed, and result-oriented. Your experience in an office environment using Windows PC applications, effective communication skills, and ability to learn new software tools will be beneficial for this position.,