Apprentice - Claims Adjudication

enGen Global; Chennai District; On-site; INR 350,000 - 550,000; Full time

Job summary

enGen Global seeks a Trainee Process Analyst in Chennai, India to join the Operations team. The role focuses on complex claims adjudication services, analyzing, validating and processing claims to meet customer requirements aligned with Highmark standards and policies.

The candidate will support ongoing operations, mentor new joiners as they gain experience, and ensure adherence to defined SLAs and quality targets within a collaborative IT and business environment.

Qualifications

• Bachelor's or Master's degree in any discipline.
• Good verbal and written skills.
• Good analytical and interpersonal skills.

Responsibilities

• Analyzing, validating, updating processing claims, and meeting scope, targets, and SLAs.
• Collaborating with customers, business analysts, partners, and IT to translate requirements into solutions.
• Providing required support for new joiners as they gain experience.
• Ensuring work complies with Highmark standards, policies and procedures.
• Communicating production quality status with team, customers, partners, and management.
• Other duties as assigned or requested.

Job description

Job Title

Trainee Process Analyst

Job Summary

This job takes the lead in providing more complex claims adjudication services typically as part of a Operations team. Claims adjudicator usually analyze, validate, update, process and adjudicate claims to meet customer requirements that adhere to Highmark standards and policies.Claims Adjudicators provide general support to maintain TAT, meet SLAs, performance and quality levels required by their customers. May mentor less experienced team members.

Essential Responsibilities

• Analyzing, validating, updating processing claims, as well as meeting defined scope, targets and SLAs.
• Collaborating with customers, business analysts, partners, and IT team members to understand business requirements that drive the innovation and quality. Concentrates on providing innovative solutions to more complex business needs.
• Providing required support for new joiners once they gain experience.
• Performs work in compliance with all Highmark and Highmark IT standards, policies and procedures.
• Effectively communicates with team members, customers, partners and management, including assisting with or conducting more complex walkthroughs, reporting production quality status.
• Other duties as assigned or requested.

Requirements

• Bachelors or Masters degree in any discipline
• Good verbal and written skills
• Good analytical and interpersonal skills