HC & Insurance Operations Associate

4 days ago


Coimbatore India NTT Data Full time

Job 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.


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