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Process Associate

We are looking for an immediate joiner who should have relevant exposure to Investigations Process with evidence gathering through fact finding and analysis.

Primary Responsibilities:

Manage administrative intake of members
Work with hospitals, clinics, facilities and the clinical team to manage requests for services from members and/or providers
Process incoming and outgoing referrals, and prior authorizations, including intake, notification and census roles
Assist the clinical staff with setting up documents/triage cases for Clinical Coverage Review
Handle resolution/inquiries from members and/or providers
Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regard to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so

Required Qualifications:

Any other undergraduates or Postgraduates can apply (Except Medical Science and Life Science graduates)
Knowledge of (HIPAA) laws pertaining to confidentiality of protected health information
Demonstrated ability to identify documentation and medical record form(s) and make independent decisions within the scope of one’s job responsibilities
Demonstrated ability to work in a team environment and to collaborate with a variety of professionals
Demonstrated ability to work occasional off-hours schedules as required
Proven extremely well versed with MS Office tools (Excel, Word and PowerPoint)
Proven good data analytical skills combined with excellent communication skills
Proven detail oriented and ability to be self-motivated to complete duties in a timely manner
Proven attention to detail with solid organizational skills
Proven basic analytical skills

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Customer Service Representative

With every role in the company, each position has a requirement for building quality into every output. The Technology Quality Function is reserved for those positions where Quality is the primary objective of the work delivered. Technology Quality roles will cover all primary quality activity across all technology functions that ensure we deliver high quality products and services. These roles include, but are not limited to, strategy, planning, standards, process, policy, tools, engineering, assurance, management, metrics, research and development, automation, data preparation, maintenance, new development, operations and delivery.

Primary Responsibilities:

Respond to customer inquiries via live chat regarding prescription refills, order status, medication availability, and insurance coverage
Educate patients on pharmacy procedures, prescription benefits, and proper medication usage
Guide patients in navigating online pharmacy platforms and mobile applications
Resolve issues related to prescription delays, billing, and insurance claims
Focus on resolving issues on the first chat, navigating through complex computer systems to identify the status of the issue and provide appropriate response to chatter
Document all interactions accurately in the system
Collaborate with pharmacists, technicians, and other departments for medication-related concerns
Escalate complex issues to appropriate personnel when necessary
Maintain compliance with HIPAA and other healthcare privacy regulations
Handle up to 2.5 concurrency Chats
Take chat messages per day from customers who have questions about their health benefits
Support secure email inquiries

Required Qualification:

Any Graduate Degree
Freshers can apply

Preferred Qualification:

Customer Service experience

Soft Skills:

General knowledge of computers and business operations
Proven ability to communicate articulately and credibly
Solid keyboard skills and experience using helpdesk, ordering or CRM software
Demonstrated ability to achieve service goals
Success in highly automated environment
Dynamic and engaging written communication style
Excellent interpersonal and business communications skills – verbal and written
Demonstrated self-motivation

Optum mega hiring freshers for Multiple role freshers apply now Full Time

Optum

About Company :

☸️ Direct access to the Referral page for members : Click here

Process Associate

Primary Responsibilities:

Required Qualifications:

Apply Link

Customer Service Representative

Primary Responsibilities:

Required Qualification:

Preferred Qualification:

Soft Skills:

Apply Link

Job Overview

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Optum mega hiring freshers for Multiple role freshers apply now Full Time

Optum

About Company :

☸️ Direct access to the Referral page for members : Click here

Process Associate

Primary Responsibilities:

Required Qualifications:

Apply Link

Customer Service Representative

Primary Responsibilities:

Required Qualification:

Preferred Qualification:

Soft Skills:

Apply Link

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