Hc & Insurance Operations Associate

Process Adjudication claims and resolve for payment and Denials - Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process - Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations -...

**Roles and Responsibilities**: - Process Adjudication claims and resolve for payment and Denials - Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process - Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits...

Process Adjudication claims and resolve for payment and Denials - Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process - Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations -...

Knowledge skills & competency required - Demonstrated ability to learn quickly and willingness to obtain functional knowledge and understanding of business procedure and policies. - 0 months to 2.5 year of customer service/ Data Entry experience - College graduate - Good verbal & written communication skills. - Demonstrated ability to work in a team...

Knowledge skills & competency required - Demonstrated ability to learn quickly and willingness to obtain functional knowledge and understanding of business procedure and policies. - 0 months to 2.5 year of customer service/ Data Entry experience - College graduate - Good verbal & written communication skills. - Demonstrated ability to work in a team...

Process Details & Primary Responsibility Process payments on behalf of Institutional MLM Group A customers and Voluntary benefits - GUL, LRK, AARP, LAPSE - Process bills / invoices and allocate cash. - Research website to review backup documentation. - Send request for additional/missing information. - Process identified suspense items distributed by Tampa...

Process Details & Primary Responsibility Process payments on behalf of Institutional MLM Group A customers and Voluntary benefits - GUL, LRK, AARP, LAPSE - Process bills / invoices and allocate cash. - Research website to review backup documentation. - Send request for additional/missing information. - Process identified suspense items distributed by Tampa...

**Experience**: - 2 years of work experience in US Health Claims processing preferably in claims adjudication **Knowledge and skills **(general and technical) **Technical Skills** - Computer navigation skills - Keyboarding and data entry speed (minimum 30 wpm with 90% accuracy) - Working knowledge of MS Excel and MS Word. - Process Specific Skills -...

**Position Requirement Summary** RIS Reviewer approver team is responsible for Processing all death cases for all product types i.e., Bulk Checks, Structured Settlements, Income Annuities, Closeout Direct Pay which are reported by the spouse, son, daughter, relative, etc. After the death process, it leads to benefit determination which is followed by...

Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose – the relentless pursuit of a world that works better for people –...

**Position Summary** The process consists of collecting, reviewing, analyzing & inputting information for generating initial rate for groups < 100 lives; interact and consult with onshore SMEs and Underwriters. **Responsibilities**: **1. **Essential Functions**: ***: - New Business Rate Generation associates are responsible for: - Data scrubbing &...

Position Summary: RIS Reviewer approver team is responsible for Processing all death cases for all product types i.e., Bulk Checks, Structured Settlements, Income Annuities, Closeout Direct Pay which are reported by the spouse, son, daughter, relative, etc. After the death process, it leads to benefit determination which is followed by sending correspondence...

**Position Summary** Front End process handles the initial implementation process for New Business Cases. The process begins after final underwriting and concludes with the enrollment process. All Automated cases (non-excluded) are routed to the GOSC for Automated case setup on the MetLife U.S Affiliated Systems. - The main steps include- Ensuring the...

**Position Summary** Front End process handles the initial implementation process for New Business Cases. The process begins after final underwriting and concludes with the enrollment process. All Automated cases (non-excluded) are routed to the GOSC for Automated case setup on the MetLife U.S Affiliated Systems. - The main steps include- Ensuring the...

Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose – the relentless pursuit of a world that works better for people –...

Genpact (NYSE: G) is a global professional services and solutions firm delivering outcomes that shape the future. Our 125,000+ people across 30+ countries are driven by our innate curiosity, entrepreneurial agility, and desire to create lasting value for clients. Powered by our purpose – the relentless pursuit of a world that works better for people –...

Job Role: Insurance Operations Executive Roles and Responsibilities: - Pleasing personality Fully conversant in MS word, excel & PowerPoint Capable of correspondence on his/her own Preferably with insurance background Willing to acquire new skill and hard working In house training will be provided Insurance/broker company background must. Typing...

Introduction A career in IBM Consulting embraces long-term relationships and close collaboration with clients across the globe. In this role, you will work for IBM BPO, part of Consulting that, accelerates digital transformation using agile methodologies, process mining, and AI-powered workflows. You'll work with visionaries across multiple industries to...

**Job Description**: Basic Function - Review the forms submitted by Bene, Employer on death claims and process the claim as per the guidelines Essential Functions - Review of the beneficiary form and enrollments form for acceptability, - Updating systems with beneficiary and enrollment requests, changes, designations, and initial solicitation at...

**Basic Function**: - Voluntary billing-P&C Account rep., is accountable for end to end billing management for Billing & Remittance customers (P&C). Facilitate a working dialog with Group contacts, stateside account managers, remittance team and internal business partners in order to provide solutions to the client billing needs. **Essential...