Business Claims Resolution Specialist

3 days ago

Chennai, Tamil Nadu, India beBeeClaims Full time ₹ 1,04,000 - ₹ 1,30,878
Job Description:

Clients face a business challenge that needs to be resolved through effective problem-solving.

Our client is a leading health plan in the US, providing services in Florida. We have entered into a contract with the client to manage end-to-end claims administration services. Our NTT Business Process Outsourcing team has implemented processes and technologies to bring about real transformation for customers of all sizes.

Our end-to-end administrative services help streamline operations, improve productivity, and strengthen cash flow to enable our customers to remain competitive and enhance member satisfaction.

General Duties and Tasks:

  • We have entered into a contract with the client to manage end-to-end health claims administration services. Our NTT Business Process Outsourcing team has implemented processes and technologies to bring about real transformation for customers of all sizes.
  • Our end-to-end administrative services help streamline operations, improve productivity, and strengthen cash flow to enable our customers to remain competitive and enhance member satisfaction.

Requirements for this role include:

  • A strong understanding of health claims end-to-end domain knowledge, acquired through 5-7 years of experience.
  • Both undergraduate and postgraduate candidates are eligible to apply.
  • Excellent communication (verbal and written) and customer service skills are essential.
  • The ability to work independently, coupled with strong analytical skills, is required.
  • Detailed-oriented individuals, with the ability to organize and multitask, are preferred.
  • The capacity to make decisions effectively is necessary.
  • Required computer skills include data entry experience, proficiency in MS Office applications, and familiarity with web-based applications.
  • Cognitive skills encompass language, basic math skills, reasoning ability, and verbal communication skills.
  • The ability to work collaboratively within a team environment is crucial.

Problem Solving:

  • Reviews structured problems.
  • Selects and applies appropriate standards/guidelines.
  • Probes beyond the stated situation.
  • Identifies underlying issues and considers possible alternatives.

Job Duty Differentiators:

  • Supervises processes and/or claims processing teams to ensure high-quality service delivery.
  • Includes the distribution of work, calculation and communication of productivity and quality results, and review of audit appeals.
  • Monitors production goals of the team and reports results and issues to higher-level leadership.
  • Assists the team with escalated claims processing issues.

Availability for this position requires working Monday-Friday from 6:00 pm to 4:00 am IST. Shift timings may change as per client requirements, and overtime or weekend work may be necessary based on business needs.

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