Claims Adjudication - Associate Claims

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Carelon Global Solutions India is seeking an Associate - Claims to manage business operations in Gurugram. The role involves processing delivery, coordinating with onshore partners, and ensuring performance as per SLA parameters.

JOB DESCRIPTION

Job Title

Associate - Claims

Requirement Type

Full-Time Employee

Job Location

Gurugram

Requirement Level

Associate - Claims

Hiring Manager

Team Lead, Business Operations

Primary Skill

Business Operations

Claims

Business

Business Operations

Skill Category

Generic

ABOUT ELEVANCE HEALTH

Elevance Health is a leading health company in America dedicated to improving lives and communities and making healthcare simpler. It is the largest managed health care company in the Blue Cross Blue Shield (BCBS) Association serving more than 45 million lives across 14 states.

A regular in Fortune 500 list, Elevance Health ranked 20 in 2022. Gail Boudreaux , President and CEO of Elevance Health has been a consistent name in the Fortune list of most powerful women and currently holds 4th rank on this list.

ABOUT CARELON

Carelon Global Solutions (CGS) is a healthcare solutions company that is simplifying complex operational processes to improve the health of the healthcare system.

Previously known as Legato Health Technologies, Carelon Global Solutions (hereinafter, CGS) underwent a name change and joined the Carelon family of brands in January 2023, as a fully owned subsidiary of Elevance Health (Previously Anthem Inc.). CGS brings together a global team of like-minded innovators who manage and optimize operational processes for health plans as well as providers.

Our brightest minds housed across our global headquarters in Indianapolis as well as Bengaluru, Hyderabad and Gurugram in India, Manila in the Philippines, Limerick in Ireland and San Juan in Puerto Rico bring with them innovative capabilities and an unmatched depth of experience. This global team uniquely positions CGS to enable scalable, next-generation platforms and specialized digital tools that make healthcare operations more practical, effective, and efficient.

OUR MISSION & VALUES

Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More.

Our Values: Leadership | Community | Integrity | Agility | Diversity

JOB POSITION

Carelon Global Solutions India is seeking a highly creative and meticulous Associate - Claims, who will be responsible for all Processing level delivery & performance as per set SLA parameters. The incumbent will report to Team Lead – Business operations and must understand the business delivery, present and metrics with leadership; brief and deliver all in-house process delivery & requirements, apart from coordinating with onshore partners as and when required.

JOB RESPONSIBILITY

Associate – Claims(Business Operations) will be responsible for the following:

BS/MS in Computer Science with minimum 1+ years of experience-Experienced/Fresher
Familiar with MS Office – basics (Excel/Power point/Outlook – primarily)
Very strong Communication & Comprehension skills with the ability to evaluate key technical/Calculations needed to deliver basic process delivery
Working knowledge on basic technologies around persistence, search, graph and distributed technologies
Excellent oral and written communication skills
Healthcare domain knowledge - nice to have
Flexible to work in any shift & in office premises per set organizational/Business requirements

QUALIFICATION

Bachelors’ or Masters’ degree in fine arts/ design
Non-BTech (preferably)

EXPERIENCE

0-2+ years of overall experience including extra-ordinary internal personal skills, communication skills
Minimum 1+ yrs experience in role applying for (on rolls)
Healthcare / Claims Experience will be added advantage

SKILLS AND COMPETENCIES

Responsible for Internal/Onshore calibration; Maintain updates tracker; Upskilling requirements & plan upskilling sessions – as needed
Manage new hire associates and plan for their training and nesting as needed
Excellent Data management – Inventory allocated; status of pended / on hold inventory
Should be able to manage and track onshore connects, suggest/drive automation ideas & demos and help them develop as needed
Conduct team huddle on process updates, internal sample audit, participate in error review/root cause at operations level and provide performance data for group aligned with
Agile & Solution centric
Inclusive
Flexible to work in any shifts/Work from office

THE CARELON PROMISE

Aligning with our brand belief of ‘limitless minds are our biggest asset’, we offer a world of limitless opportunities to our associates.

It is our strong belief that one is committed to a role when it is not just what the role entails, but also what lies in its periphery that completes the value circle for an associate.

This world of limitless opportunities thrives in an environment that fosters growth and well-being, and gives you purpose and the feeling of belonging.

LIFE @ CARELON

Extensive focus on learning and development
An inspiring culture built on innovation, creativity, and freedom
Holistic well-being
Comprehensive range of rewards and recognitions
Competitive health and medical insurance coverage
Best-in-class amenities and workspaces
Policies designed with associates at the center

EQUAL OPPORTUNITY EMPLOYER

Carelon is committed to a diverse and inclusive workplace and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Reasonable Accommodation

Our inclusive culture empowers Carelon to deliver the best results for our customers. We not only celebrate the diversity of our workforce, but we also celebrate the diverse ways we work.

If you have a disability and need accommodation such as an interpreter or a different interview format, please ask for the Reasonable Accommodation Request Form.

Disclaimer: Offered designation titles differ*

Extra Job Content

This is an example of some common job content that can be shown at the bottom of every job description. It is added in the CMS and then shown on every job. It can be used to supplement the job content that comes from the ATS.

Set alert for similar jobsClaims Adjudication - Associate Claims role in Bangalore Urban, India

Company

Carelon

Job Posted

a year ago

Job Type

Full-time

WorkMode

On-site

Experience Level

0-2 years

Locations

Bangalore Urban, Karnataka, India

Qualification

Bachelor or Master

Applicants

21 applicants

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