HC Insurance Operations Associate

3 weeks ago

Chennai, Tamil Nadu, India timesjobs Full time
## :
HC & Insurance Operations Associate

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Date: May 10, 2024

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Location: Chennai, TN, IN

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Company: NTT DATA Services

### 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, copay, 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 preestablished guidelines
### Requirements:

  • 13 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 weekends basis business requirement.

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