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HC & Insurance Operations Sr Associate at NTT DATA

Coimbatore, tamil nadu, India -

Full Time

Start Date

Immediate

Expiry Date

13 Feb, 26

Salary

0.0

Posted On

15 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Adjudication, Authorization Handling, COB, Duplicate Claims Processing, Pricing Claims Process, Healthcare Insurance Policy Knowledge, Client SLA Management, Task Organization, Analytic Skills, Communication Skills, Facets Experience, HCFA Claims, UB Claims, Independent Work, Problem Resolution, Guideline Adherence

Industry

IT Services and IT Consulting

Description

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 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

Responsibilities

The role involves processing adjudication claims and resolving issues related to payment and denials. It requires ensuring accurate and timely completion of transactions to meet client service level agreements (SLAs).