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Associate - Operations at WNS Global Services

Pune City, maharashtra, India -

Full Time

Start Date

Immediate

Expiry Date

24 Jul, 26

Salary

0.0

Posted On

25 Apr, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Operations, Claims processing, Data entry, Customer service, Benefit eligibility, Authorization management, Inpatient admission, Outpatient precertification, Prior authorization, Telephone inquiries, Written inquiries, Customer relations, Utilization management

Industry

Business Consulting and Services

Description

Company Description WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving more than 700 clients across 10 industries, including Banking and Financial Services, Healthcare, Insurance, Shipping and Logistics, and Travel and Hospitality. We bring together deep domain excellence – WNS’ core differentiator – with AI-powered platforms and analytics to help businesses innovate, scale, adapt and build resilience in a world defined by disruption.Our purpose is clear: to enable lasting business value by designing intelligent, human-led solutions that deliver sustainable outcomes and a differentiated impact. With three global headquarters across four continents, operations in 13 countries, 65 delivery centers and more than 66,000 employees, WNS combines scale, expertise and execution to create meaningful, measurable impact. Job Description The primary job function will include:• Managing incoming calls or incoming post services claims work• Determines contract and benefit eligibility; provides authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests• Refers cases requiring clinical review to a Nurse reviewer• Responsible for the identification and data entry of referral requests into the UM system • Responds to telephone and written inquiries from clients, providers and Aetna’s internal departments• Checks benefits for facility-based treatment• Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner. Qualifications Undergraduate/Graduate

Responsibilities

The associate will manage incoming claims, determine benefit eligibility, and process authorizations for inpatient and outpatient services. They are also responsible for data entry into the utilization management system and handling inquiries from clients and providers.