Benefit Adjuster I
Segment · All India
- Experience0–4 yrs
- SalaryNot disclosed
- Work modeonsite
- Posted29 Sept 2026
About Segment
Segment is hiring in All India in technology software. This role looks for around 0+ years of experience.
Skills
- anatomy and physiology
- CPT and ICD10 coding
- contract knowledge
- Microsoft Windows
- customer service
The role
A health operations associate at an insurance company evaluates and processes medical insurance claims using medical terminology, anatomy and physiology, and CPT and ICD10 coding, while assisting customers and medical providers with coverage needs. Contract knowledge and customer service support accurate claim handling.
Full job description
* Evaluates and processes claims that require routine judgement and investigation such as Diagnostic Testing, Wellness, Physician Expense, URM, GAP, Hospital Indemnity, Medlink, Dental, Triage/Incomplete or Pregnancy claims in accordance with Company policy terms, insurance laws, regulatory requirements and adjusting guidelines.
* Provides appropriate verbal and/or written communication to internal and external Customers in a positive and knowledgeable manner to ensure a high standard of Customer service. Meets standards established in department performance metrics for appropriate handling of Customer phone calls.
* Acts as a direct contact and communicates with Customers and medical providers in a positive, knowledgeable and professional manner, providing them with direction and assistance in all facets of insurance coverage and needs.
Education & Certification
High school diploma or general education degree (GED)Technical Skills & Requirements
Prompt and reliableGood medical terminology preferredPossesses General PC Windows-based software knowledge with the ability to learn new applications and work in a paperless environmentGood understanding of anatomy and physiologyGood contract knowledgeFamiliarity with CPT and ICD10 codingPossesses good analytical skills and judgmentAbility to be flexible in work schedule, including a willingness to work overtime as neededGood oral and written communication skillsAbility to handle fast-paced environmentProfessional attitudeDedicated to providing world-class Customer serviceAbility to work well within a team environment
#AFC
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