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HC & Insurance Operations Associate at NTT DATA
Coimbatore, tamil nadu, India -
Full Time

Start Date

Immediate

Expiry Date

06 Feb, 26

Salary

0.0

Posted On

08 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Claims Adjudication, Healthcare Insurance, Analytic Skills, Communication Skills, Authorization Handling, COB Knowledge, Duplicate Claims, Pricing Claims, Corrected Claims, In Network Providers, Out Of Network Providers, Deductible Knowledge, Coinsurance Knowledge, Co-Pay Knowledge, Out Of Pocket Maximum, State Variations

Industry

IT Services and IT Consulting

Description
Roles and Responsibilities: • Process Adjudication claims and resolve for payment and Denials • Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process • Knowledge of healthcare insurance policy concepts including in network, out of network providers, deductible, coinsurance, co-pay, out of pocket, maximum inside limits and exclusions, state variations • Ensuring accurate and timely completion of transactions to meet or exceed client SLAs • Organizing and completing tasks according to assigned priorities. • Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team • Resolving complex situations following pre-established guidelines Requirements: • 1-3 years of experience in processing claims adjudication and adjustment process • Experience of Facets is an added advantage. • Experience in professional (HCFA), institutional (UB) claims (optional) • Both under graduates and post graduates can apply • Good communication (Demonstrate strong reading comprehension and writing skills) • Able to work independently, strong analytic skills **Required schedule availability for this position is Monday-Friday 5.30PM/3.30AM IST (AR SHIFT). 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 HC & Insurance Operations Associate will process adjudication claims, resolve payment and denial issues, and ensure timely completion of transactions. The role requires organizing tasks according to priorities and developing knowledge of healthcare insurance products and processes.