Posted by Capgemini SE is a French multinational corporation that provides consulting, technology, professional, and outsourcing services. It is headquartered in Paris, France. Capgemini has over 200,000 employees in over 40 countries, of whom nearly 120,000 are in India.
Claims Associate
Job Description:
o Freshers from Science Graduates, B-Pharma or life science graduates
o Should have a minimum of 30 wpm typing speed
o Should have knowledge of Medical terminology, human anatomy with basic math knowledge of calculating simple interest, compound interest.
o Should have good comprehension and analytical skills
o Should have excellent problem-solving skills
o Should have positive approach and open to learn process dynamics
o Should have good communication, verbal and written English
o Should be open to work 24*7 and mandatory
o Ready to handle work pressure and ensure deliverables within timelines
Experience:
o candidates should have at least 1.5 years of experience in Claims and science graduation backgroundo candidates should have a minimum of 3 years in claims experience with science graduation backgroundo Should have in-depth knowledge of ICD 10, CPT, Surgery procedures, Revenue codeso Should have an experience of reading and comprehending Medical reportsTranscription or Medical underwriting experience will be added advantage
Candidates should be flexible / willing to work across this delivery landscape which includes and not limited to Agile Applications Development, Support and Deployment.
o Processing Accident claims on daily basis (preference will be given Accident Claims skill set)o Processing around 80 to 90 claims daily within a set quality parameter
o Should have strong English & Science knowledge to comprehend Medical reports
o Job involves written communication to US policyholders on their claims status and documentation requirement to process the claim
o To ensure claims are adjudicated as per the guidelines of the company. Provide continual evaluation of processes and procedures.
o To respond to and resolves claims received via emails.
o Candidate should be able to correctly calculate claim amounts for the customers
o Complying with company regulations regarding HIPAA, confidentiality, and private health information
o Outbound call making skills for gathering missing information in order to process claims
o The resource should have eye for detail while reviewing work for colleagues or self.