JOB ROLES: Process Trainee
Location : Chennai,Hyderabad
JOB DESCRIPTION:
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. Our global collaborative of healthcare, operations, and IT experts creates innovative and sustainable processes for our clients, which keeps the ever-evolving consumers engaged and assists them in managing the future of their healthcare better. We recognize that our people are our strength and the diverse talents they bring to our global workforce are directly linked to our success. Thryve is an equal opportunity employer and places a high value on integrity, diversity, and inclusion in the organization. We do not discriminate on the basis of any protected attribute.
For more information about the organization, please visit www.thryvedigital.com
Job Description:
Responsibilities: This role requires to screens, reviews, evaluate online entry, error correction and / or quality control review and final adjudication of paper/electronic claims. Determines whether to return, deny or pay claims following organizational policies and procedures. May include initial entry claims or claims which have suspended. Translate foreign language claims into English using software and code appropriately. Convert foreign currency to US dollar and code charges appropriately. Reviews processed claims and inquiries to determine corrective action which can include adjusting claims. Takes the corrective action steps using enrollment, benefit, and historical claim processing information. • Determine if claim information is complete and correct. Enter/verify claims data. • Resolve claim edits, review history records, and determine benefit eligibility for service. Review payment levels to arrive at final payment determination. • Meets all production and quality standards. Attends all required training classes. • Elevates issues to next level of supervision, as appropriate. • Maintains accurate records, including timekeeping records. • Other duties as assigned or requested
Education Required:
Bachelor of Arts (B.A) – Any Specialization • Bachelor of Commerce (B. Com) – Any Specialization • Bachelor of Science (B.Sc.)
SKILLS REQUIRED:
• Should be flexible working for US shifts. • Should have good typing skills (30-35 wpm). • Should have good English communicational skills (both oral and written). • Knowledge in US Healthcare would be an added advantage. • Should be open & flexible to align with business requirements as needed
