
Claim Adjudication
20 hours ago
NTT Data Services is Hiring 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 competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. Client's business problem to solve? For more than 30 years, our Business Process Outsourcing (BPO) team has implemented the processes and technologies for our clients that 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 help our customers stay competitive and improve member satisfaction. Position's General Duties and Tasks In this Role you will be Responsible For - Reviewing and researching insurance claims to determine possible payment accuracy. - Validating Member, Provider and other Claims information. - Determining accurate payment criteria for clearing pending claims based on defined Policy and Procedure. - Coordinating Claim Benefits based on the Policy & Procedure. - Maintaining productivity goals, quality standards and aging timeframes. - Scrutinizing Medical Claim Documents and settlements. Requirements for this role include: - 2 to 3 years of Claims Adjudication experience that required you to review claims rules and workflows. - Experience in audit process is preferrable. - Experience in Claims Platform AMISYS or Xcelys is preferrable - 2 to 3 years of experience processing claims that required a working knowledge of HCPCS, ICD and CPT codes - 2 to 3 years of experience that required a 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. - Ability to communicate (oral/written) effectively in English to exchange information with our client. **Required schedule availability for this position is Monday-Friday (US Shift).**
**Job Types**: Full-time, Regular / Permanent
**Salary**: ₹230,000.00 - ₹300,000.00 per year
**Benefits**:
- Cell phone reimbursement
- Health insurance
- Provident Fund
- Work from home
Schedule:
- Night shift
Supplemental pay types:
- Performance bonus
- Shift allowance
Ability to commute/relocate:
- Chennai, Tamil Nadu: Reliably commute or planning to relocate before starting work (required)
**Experience**:
- Claim Adjudication (required)
- Health insurance
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