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HC & Insurance Operations Senior Rep at NTT DATA
Chennai, tamil nadu, India -
Full Time

Start Date

Immediate

Expiry Date

23 Jan, 26

Salary

0.0

Posted On

25 Oct, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Provider Data Management, Provider Data Enrollment, Credentialing, Claims Management, Claims Denial Management, End to End Provider Billing, EDI Rejection Claims, Patient Demographic Changes, Provider Demographic Changes, Amisys, Cenprov, Medicaid, Medicare, Contract Information, Quality Standards, Communication Skills

Industry

IT Services and IT Consulting

Description
PROVIDER DATA MANAGEMENT - GRADE 5 Associate will process and update Provider Data Management and Provider Data Enrollment Resources to the Client's main application according to its policies and procedures defined. In-depth knowledge and experience in the US healthcare (Non Voice) - Provider Data Validation and Provider Data management. Candidate should have 5 years and above experience in US healthcare and into provider enrollment and credentialling. Ensures day-day transactions are processed per standard operating procedures. Follows Work process flow to ensure pends are completed and maintain Quality and timeliness standards. Knowledge in Amisys and Cenprov application are preferred. Product knowledge in checking affiliation for Medicaid, Medicare and Exchange. Everyday checked Contract information in Payment Index such as, Pay class, override key, accepts code and etc. Ability to read and understand the provider contract. Handling Paid claims and recouped claims. Claims Rejections handling. Working in claims denial management. Knowledge about End to End provider billing process. Working knowledge in EDI rejection claims Handing Patient and provider demographic changes. 3 to 5 years of experience in US healthcare working with Provider Data Enrollment and Management. Ability to work in a 24/5 environment; shifts can be rotational. University degree or equivalent that required 3+ years of formal studies. Ability to work in a team environment. Good logical thinking ability. Good English Comprehension/written skills should have exposure to MS Office. Good Communication Skills - Both Verbal and Written Ability to interact with clients preferred.
Responsibilities
The Associate will process and update Provider Data Management and Provider Data Enrollment Resources according to defined policies and procedures. They will ensure day-to-day transactions are processed per standard operating procedures and maintain quality and timeliness standards.