Coordination of Benefits Associate at NTT DATA

Plano, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

13 Apr, 26

Salary

0.0

Posted On

13 Jan, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Coordination Of Benefits, Medical Claims, Eligibility Experience, Insurance Verification, Claims System Update, Regulatory Compliance, HIPAA Knowledge, Microsoft Office Suite, Windows PC Applications, Typing Skills, Research Skills, Communication Skills, Problem Solving, Quality Standards, Productivity Standards, Workflow Facilitation

Industry

IT Services and IT Consulting

Description

Use multiple sources in researching the potential of dual coverage and determining which Insurance is primary. Update Claims System according to Member insurance Making outbound call to other Insurance companies to verify coverages Take up additional training/ new assignments or projects that may come up as per client needs. Meet/ exceed required performance measures such as quality and productivity standards Meet/ exceed process SLAs Successfully complete the required regulatory and compliance requirements such as the HIPAA. Successfully complete all organizational and client training requirements Understand how work impacts results for their area as well as other processes. Demonstrate knowledge of internal operations and develops relationships to facilitate workflow. Use multiple sources in researching the potential of dual coverage and determining which Insurance is primary. Update Claims System according to Member insurance Making outbound call to other Insurance companies to verify coverages Take up additional training/ new assignments or projects that may come up as per client needs. Meet/ exceed required performance measures such as quality and productivity standards Meet/ exceed process SLAs Successfully complete the required regulatory and compliance requirements such as the HIPAA. Successfully complete all organizational and client training requirements Understand how work impacts results for their area as well as other processes. Demonstrate knowledge of internal operations and develops relationships to facilitate workflow. Knowledge of related regulations and standards. Strong understanding of current processes and procedures and may identify opportunities for improvement. Using multiple sources, this position will research the Coordination of Benefits (COB) for potential dual coverage by other health insurance companies for all subscribers, spouses, and affected dependents and determines which insurance is prime. COB research extends to all coverage offered by Health Net Strong understanding of current processes and procedures and may identify opportunities for improvement. Additionally, resources may have to do overtime and work on weekend's basis business requirement. On the phones about 30% of the day High school Diploma or equivalent. 3+ years of medical claims or eligibility experience 5+ years of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, leverage internet search engines, and other web-based applications. 5+ years of experience with the Microsoft Office suite that required daily usage of Outlook, Excel and Word. Ability to type 40 WPM Required schedule availability for this position is Monday-Friday (08:00am to 08:00pm CST/EST) . The shift timings can be changed as per client requirements. Typing and Computer skills assessment High school Diploma or equivalent. 3+ years of medical claims or eligibility experience 5+ years of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, leverage internet search engines, and other web-based applications. 5+ years of experience with the Microsoft Office suite that required daily usage of Outlook, Excel and Word. Ability to type 40 WPM Required schedule availability for this position is Monday-Friday (08:00am to 08:00pm CST/EST) . The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend's basis business requirement.

Responsibilities

The Coordination of Benefits Associate will research potential dual coverage and determine primary insurance for members. They will also update the claims system and make outbound calls to verify coverages.