Trainee - Claims Adjudicator

2 weeks ago

Hyderabad, India Thryve Digital Full time

Process Analyst
- Thryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation solutions that enable our healthcare partners to provide positive experiences to their consumers.- Role Summary:

- This job takes the lead in providing more complex claims adjudication services typically as part of an Operations team. Claims adjudicator usually analyze, validate, update, process and adjudicate claims to meet customer requirements that adhere to Highmark standards and policies. Claims Adjudicators provide general support to maintain TAT, meet SLA’s, performance and quality levels required by their customers. May mentor less experienced team members.
- Essential Responsibilities- Analyzing, validating, updating & processing claims, as well as meeting defined scope, targets and SLA’s.
- Collaborating with customers, business analysts, partners, and IT team members to understand business requirements that drive the innovation and quality. Concentrates on providing innovative solutions to more complex business needs.
- Providing required support for new joiners once they gain experience.
- Performs work in compliance with all Highmark and Highmark IT standards, policies and procedures.
- Effectively communicates with team members, customers, partners and management, including assisting with or conducting more complex walkthroughs, reporting production & quality status.
- Other duties as assigned or requested.

The experience we are looking to add to our team
- Required- Bachelor’s or Master’s degree in any discipline
- Good verbal and written skills
- Good analytical and interpersonal skills

**Short Info**:

- Posted: 0 day(s) ago- Qualifications: Graduation- Experience: 0 Years To 1 Years

  • Senior Analyst Claims Adjudication

    5 days ago

    Hyderabad, Telangana, India Data Marshall Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Job DescriptionMinimum 2 years of experience in Claims AdjudicationUnderstands claims processing on both professional and facility claimsAbility to understand provider contractsProficient keyboard skills, with a minimum typing speed of 25 words per minute.Strong attention to detail and analytical thinking capabilities.Ability to work independently as well as...

  • Claim Processor

    2 weeks ago

    Gurugram, Hyderabad, Mumbai, India Career Shaper Full time ₹ 6,00,000 - ₹ 12,00,000 per year

    OPEN FOR FRESHERS BHMS AND BMS DOCTORSKnowledge of Claims processes: Indemnity (Cashless, Reimbursement), Fixed Benefit ProductsUnderstanding of Claims systems (process flow & System fields) Health, PA & TravelExperience in measurement of performance (TAT, accuracy in claims adjudication)Expectations management of the Claims teamTAT & expectations management...

  • Pega Smart Claims

    3 weeks ago

    Hyderabad, India Religent Systems Full time

    Key Responsibilities Design, develop, and implement solutions on Pega Smart Claims platform for insurance/healthcare domain. Configure and customize Pega rules, flows, case types, data pages, activities, decision tables, and integrations. Work closely with business stakeholders to gather requirements and translate them into functional and technical...

  • Pega Smart Claims

    1 week ago

    Hyderabad, Telangana, India Religent Systems Full time ₹ 20,00,000 - ₹ 25,00,000 per year

    Key ResponsibilitiesDesign, develop, and implement solutions on Pega Smart Claims platform for insurance/healthcare domain.Configure and customize Pega rules, flows, case types, data pages, activities, decision tables, and integrations.Work closely with business stakeholders to gather requirements and translate them into functional and technical...

  • Claims Associate

    3 weeks ago

    Hyderabad, India Optum Full time

    Job Description Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion,...

  • Claims Associate

    3 weeks ago

    Hyderabad, India Optum Full time

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers,...

  • Claims Associate

    3 days ago

    Hyderabad, Telangana, India Optum Full time ₹ 2,40,000 - ₹ 5,44,000 per year

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers,...

  • Claims Associate

    1 week ago

    Hyderabad, India UnitedHealth Group Full time

    Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers,...

  • Medical Officer

    3 weeks ago

    Hyderabad, India Good Health Tpa Services Full time

    Looking for freshers* Processing of Cashless Requests & Health Insurance Claims for TPA / Insurance company * Process and Provide Medical opinion for Health Insurance Claims* Understanding of Claims adjudication / Claims Processing

  • Medical Officer

    2 weeks ago

    Hyderabad, Telangana, India Good Health Tpa Services Full time ₹ 4,00,000 - ₹ 12,00,000 per year

    Looking for freshers* Processing of Cashless Requests & Health Insurance Claims for TPA / Insurance company * Process and Provide Medical opinion for Health Insurance Claims* Understanding of Claims adjudication / Claims Processing