Hc & Insurance Operations Associate

2 days ago


Coimbatore, India NTT DATA Full time

HC & Insurance Operations Roles and Responsibilities:

- 2-3 years of experience in processing claims adjudication and adjustment process
- Experience in professional (HCFA) and institutional (UB) claims
- Knowledge in handling authorization, COB, duplicate and pricing 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
- Audit claims as outlined by Policies and Procedures. Utilize appropriate system-generated reports applicable for specialty claims.
- Document, track findings per organizational guidelines for reporting purpose.
- Based upon trends, determine ongoing Claims Examiner training needs and develop/implement training programs as approved by Senior Management.
- Conduct in-depth research of contract issues, system-related problems, claims processing Policies and Procedures, etc., to confirm cause of trends. Recommend actions/resolutions to Senior Management.
- Work with other organizational departments to develop corrective action plans to improve accuracy of the claims adjudication processes and assure compliance with organizational requirements and applicable regulations.
- Assist in the development of Claims Department Policies and Procedures.
- Attend organizational meetings as required
- Adhere to organizational Policies and Procedures.

**Requirements**:

- 2-3 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 Work Timings: 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 2-3 years of relevant experience



  • Coimbatore, India Hashmap Full time

    We are currently seeking a HC & Insurance Operations Associate to join our team in Coimbatore, Tamil Nadu, India. In this Role you will be Responsible For - Review and process insurance claims. - Validate Member, Provider and other Claims information. - Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure. -...


  • Coimbatore, India Hashmap Full time

    NTT Data Services is Hiring! Grade 3 - HC & Insurance Operations Sr Rep **Position's Overview** At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company’s growth, market presence and our ability to help our clients stay a step ahead of the...


  • Coimbatore, Tamil Nadu, India NTT DATA Full time

    We are currently seeking a HC & Insurance Operations Associate to join our team in Coimbatore, Tamil Nadu, India. In this Role you will be Responsible For - Review and process insurance claims. - Validate Member, Provider and other Claims information. - Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure. -...


  • Coimbatore, Tamil Nadu, India NTT DATA Full time

    NTT Data Services is Hiring! Grade 3 - HC & Insurance Operations Sr Rep **Position's Overview** At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the...


  • Coimbatore, Tamil Nadu, India NTT DATA Full time

    **Req ID**: 281034 We are currently seeking a HC & Insurance Operations Associate to join our team in Coimbatore, Tamil Nādu (IN-TN), India (IN). **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...

  • Bpo Hc

    4 days ago


    Coimbatore, Tamil Nadu, India NTT DATA Full time

    At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure...


  • Coimbatore, Tamil Nadu, India NTT DATA Full time

    At NTT DATA we know that with the right people on board anything is possible The quality integrity and commitment of our employees are key factors in our company s growth market presence and our ability to help our clients stay a step ahead of the competition By hiring the best people and helping them grow both professionally and personally we ensure...


  • Coimbatore, Tamil Nadu, India NTT DATA Full time

    At NTT DATA we know that with the right people on board anything is possible The quality integrity and commitment of our employees are key factors in our company s growth market presence and our ability to help our clients stay a step ahead of the competition By hiring the best people and helping them grow both professionally and personally we ensure...


  • Coimbatore, Tamil Nadu, India NTT Data Full time

    Job DescriptionPosition's General Duties and TasksIn this Role you will be Responsible For :. Read and understand the process documents provided by the customer.. Entry-level administrative operations support performing various basic tasks (mail, file services, reporting, project support, and general account support activities).. Analyze the insurance...


  • Coimbatore, India Hashmap 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...