Claims Associate Jobs in Hyderabad - JoulesToWatts Business Solutions Pvt Ltd
Job Description
Selection Criteria
- Aptitude Test
- Typing test 40 words per minute (wpm)
- Final Interview Round
- Work Information
- Shift Time:5:45pm - 3:15am or 8:45pm- 6:15am
- Experience:Fresher’s needed
- Review completed projects for accurate implementation based on requests received and applied logic of RxCLAIM;
- Perform test claims (as applicable) and document results to ensure requests were completed accurately in the system;
- Perform root cause analysis of errors identified (if applicable);
- Assess and communicate financial impact of the errors identified to BOM management (if applicable);
- Validate audit findings with affected parties and confirm corrected (if applicable);
- Recommend solutions to mitigate/fix the errors noted and review them with affected parties for an agreed upon approach, as appropriate;
- Document work performed and audit results based on pre-determined standards and guidelines.
- User Acceptance Testing (UAT) is preformed to ensure system changes and/or enhancements are properly tested and acceptable prior to implementation.
- Work with Client Management to review the implemented new and maintain existing benefits and client pricing in the pharmacy claim adjudication system.
- Ensure timely communication of any issues and/or information needed to complete a plan request.
- Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests.
- Maintain acceptable and appropriate quality levels and production turnaround times
- Adhere to all documentation standards within the department.
- Assist with the development of process improvements for the department.
- Research and respond to all claims processing inquiries from Client
- Applies knowledge/skills to complex activities.
- Demonstrates a depth and breadth of knowledge/skills in own area and is often able to apply these outside of own function.
- Often acts as a technical resource to others in own function.
- Anticipates customer needs and proactively identifies solutions.
- Solves complex problems on own; proactively identifies new solutions to problems.
- Plans, prioritizes, organizes and completes work to meet established objectives.
- Acts as a facilitator to resolve conflicts on team; seen as key team member on project teams spanning more than own function.
- Performance Standard:
- Ability to maintain an accuracy rate of 99.70% or better
- Able to work independently
- Completes assigned projects on time
- Adherence to company attendance policy
- Microsoft Office proficiency Word and Excel, specifically Advanced Excel skills -- must have ability to create Excel spreadsheet, macros, compile/analyze data for reporting
- Strong written and verbal skills
- Detail-oriented
- Superior organization skills
- Ability to work on multiple projects simultaneously
- Excellent analytical skills.
- Certified pharmacy technician preferred
- Degree in B.Pharma / M.pharma / M.Sc in Biotechnology / Recognized Nursing course.
- Should be Flexible to work in Night Shifts.
Job Particulars
Role others
Who can apply Freshers
Hiring Process Written-test, Face to Face Interview
Employment TypeFull Time
Job Id313320
Job Category BSc/BCA/BBM , Others
Locality Address
State Telangana
Country India
About Company
JoulestoWatts is a business solutioning and consulting company that delivers client-focused and multi-disciplinary solutions. Our strength is in overcoming complex challenges to deliver sustainable value and profits to clients on time. We believe in our ability to positively impact our clients’ businesses across industry verticals with customised solutions, technology-driven services and rigorous analytics. This unique capability has enabled us to uncover insights, leading to smart decisions, supported by the best technologies and operational processes.In short, we empower clients with relentless innovation, extraordinary growth and therefore, profits.
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