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