Sr Claims Associate Opening @ UST Global

We are a leading IT company with more than 14000 employees. We are one of the fastest companies to attain CMM Level 5, CMMi, and PCMM Level 5. We have vast experience in software solutions for areas like retail, banking & financial services, airlines, healthcare, shipping & transportation, networking, telecommunications automobiles and manufacturing.

Designation	Sr Claims Associate
Job Description	We are looking candidates for the below mentioned requirement, if the JD is of your interest please share your updated resume to akila.kothandam@ust-global.com with the below mentioned details:- CTC: ECTC: Exp: NP: CANDIDATE SHOULD BE COMFORTABLE WORKING IN SHIFTS Benefit Analyst Responsibilities Analyze benefit requests and secure all necessary data to ensure appropriate. implementation based on applied logic of RxCLAIM (by SXC) pharmacy claim adjudication system.  o Work with Client Management to implement new and maintain existing benefit plans and client pricing in the pharmacy claim adjudication system.  o Work with Clinical Pharmacy to implement formulary updates and clinical programs in the pharmacy claim adjudication system.  o Work with Pharmacy Network Management to implement pharmacy rate changes and network additions in the pharmacy claim adjudication system. Ensure timely communication of any issues and/or information needed to complete a plan request. Develop client specific implementation plans and manage implementation processes in accordance with department protocol. Run queries out of the RxCLAIM adjudication system to secure all necessary information to implement plan requests.  Develop and run macros in RxCLAIM to implement plan requests. Perform claim testing to ensure accurate claim adjudication. Maintain acceptable and appropriate quality levels and production turn around times Adhere to all documentation standards within the department. Assist with the development of process improvements for the department. Research and respond to all claims processing inquiries from Client Management, Clinical, and other internal department. Participate in team meetings. May be assigned to work on special projects and business initiatives. Performance Standard Ability to maintain an accuracy rate of 98% or better Adherence to company attendance policy Able to work independently Completes assigned projects on time. Skills Microsoft Office proficiency Word and Excel, specifically Advanced Excel skills -- must have ability to create Excel spreadsheet, macros, compile/analyze data for reporting; Strong written and verbal skills; Detail-oriented; Superior organization skills; Ability to work on multiple project simultaneously; and Excellent analytical skills. Qualifications Certified pharmacy technician preferred; Bachelor's Degree or equivalent experience; 2+ years of RxCLAIM (by SXC) experience (desired); and/or 2+ years PBM or retail pharmacy experience (required).
Desired Profile	Please refer to the Job description above
Experience	1 - 3 Years
Industry Type	BPO / Call Centre / ITES
Role	Associate/Senior Associate -(NonTechnical)
Functional Area	ITES, BPO, KPO, LPO, Customer Service, Operations
Education	UG - Any Graduate - Any Specialization, Any Specialization, Any Specialization, Any Specialization, Graduation Not Required PG - Any Postgraduate - Any Specialization, Any Specialization, Any Specialization, Any Specialization, Post Graduation Not Required DOCTORATE - Any Doctorate - Any Specialization, Any Specialization, Any Specialization, Any Specialization, Doctorate Not Required
Location	Hyderabad / Secunderabad
Keywords	Ms Office, Clinical Pharmacy, Claims Processing, Technician Activities, Organization Skills, Network Management, Advanced Excel, Client Management, Analytical Skills
Contact	Manoj US Technology International Pvt Ltd
Website	http://www.ust-global.com
Job Posted	07 Jul