Hc & Insurance Operations Associate

2 days ago

Coimbatore, India NTT Data Services Full time

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 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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