Healthcare Operations Associate - Health Payer Services
Work Location
Work from Office (WFO)
Work Mode
Hybrid Model
Shift Timings
5:00 PM to 2:30 AM IST
Career Level
Level 13
Role Overview
We are seeking detail-oriented and customer-focused professionals to support key healthcare payer operations. The role involves managing member enrollment activities, premium billing, payment application processes, provider demographic maintenance, medical claims processing, and handling provider/member inquiries. The ideal candidate should possess robust analytical skills, accuracy in data processing, and the ability to work effectively in a fast-paced environment while ensuring adherence to quality and compliance standards.
Key Responsibilities
Member Enrollment & Eligibility
- Process member enrollment, maintenance, and eligibility transactions accurately and within defined timelines.
- Review and validate member information to ensure completeness and compliance with payer policies.
- Perform updates, corrections, and changes related to member records.
- Ensure data integrity across healthcare systems and databases.
Premium Billing & Payment Processing
- Support premium billing activities and payment application processes.
- Reconcile billing discrepancies and investigate payment-related issues.
- Process adjustments, refunds, and account updates as required.
- Maintain accurate financial records and documentation.
Provider Data Management
- Update and maintain provider demographic information in the system.
- Verify provider details and ensure accurate record maintenance.
- Support provider onboarding and profile update activities.
- Collaborate with internal stakeholders to resolve provider data issues.
Claims Processing
- Review, validate, and process medical claims according to established guidelines and service-level agreements.
- Identify and investig
📌 Healthcare Processor (Chennai)
🏢 Artech Infosystems Private
📍 Chennai
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