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Associate III

2 weeks ago

Chennai, Tamil Nadu, India UST Full time ₹ 4,00,000 - ₹ 8,00,000 per year

Job Title: Claims Adjudication - Non-Voice BPO Process

Experience: 3 to 7 Years

Location: Chennai

Process Type: Non-Voice (Back Office)

Domain: Healthcare / Insurance

Shift: 5.30pm to 2.30pm or 6.30pm to 3.30pm

Job Summary:

We are seeking a detail-oriented and experienced Claims Adjudicator to join our non-voice BPO team. The ideal candidate will be responsible for reviewing, processing, and adjudicating healthcare/insurance claims in accordance with policy guidelines, while ensuring accuracy and compliance with industry standards.

Key Responsibilities:

  • Review and adjudicate healthcare/insurance claims as per standard operating procedures.

  • Interpret and validate claim data including member eligibility, provider details, and service coding.

  • Ensure timely and accurate processing of claims with high attention to detail.

  • Identify discrepancies or inconsistencies in submitted claims and initiate corrective actions.

  • Maintain productivity and quality benchmarks as per SLA.

  • Communicate effectively with internal teams for clarifications and escalations.

  • Adhere to compliance, confidentiality, and data protection protocols.

Required Skills:

  • 3-7 years of experience in Claims Adjudication within a BPO/Healthcare environment.

  • Strong understanding of claims processing rules, ICD/CPT codes, and insurance policies.

  • Hands-on experience with claims adjudication tools and healthcare systems.

  • Good analytical and problem-solving skills.

  • Ability to work in a fast-paced and target-driven environment.

  • Proficiency in MS Office (Excel, Word).

  • Strong attention to detail and accuracy.

  • Willingness to work in rotational shifts

Required Skills

Healthcare,Call Center,Call Center Operations,Claims Processing