Hc & Insurance Operations Associate

1 week ago

Chennai, Tamil Nadu, India NTT Data Services Full time
Review and process insurance claims.

  • Validate Member, Provider and other Claim's information.
  • Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
  • Coordination of Claim Benefits based on the Policy & Procedure.
  • Maintain productivity goals, quality standards and aging timeframes.
  • Scrutinizing Medical Claim Documents and settlements.
  • Organizing and completing tasks per 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 preestablished guidelines

Requirements for this role include:

  • University degree or equivalent that required formal studies of the English language and basic Math
  • 2+years of adjudication experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
  • 6+ months of experience that required prioritizing your workload to meet deadlines

Preferences:

  • Optional (nicetohave's)
  • Ability to communicate (oral/written) effectively to exchange information with our client.
Required schedule availability for this position is Monday-Friday (06:00pm to 04:00am IST). 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.

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