hc & insurance operations analyst

1 day ago

Chennai, Tamil Nadu, India NTT DATA Full time ₹ 2,50,000 - ₹ 7,50,000 per year

Role Responsibilities:

  • In-depth knowledge and experience in the US healthcare (Non Voice) - Membership enrollment and billing.
  • Ability to train the team on new process and process updates.
  • Calibrate with QA's to ensure process knowledge and variance are managed and under control.
  • Ability to create Process SOP, Process Map and identifying the outlier within process.
  • Review Discrepancy report and comments, identify gaps and share with TL.
  • Identify NVA and provide suggestion for automation opportunities.
  • Identify refresher/re-trainable topics, conduct assessments, and certify staff to move to different levels of production.
  • Drive team from the front in case of leadership unavailability.
  • Need to co-ordinate with quality team to identify the root cause and provide appropriate solution to overcome errors.
  • Oversee data integrity of member enrollment records and remittance files transmitted from the state.
  • Provide timely, efficient support for the eligibility load process while coordinating with corporate IS department to resolve issues that arise during the process.
  • Provide research to correct errors in membership and Primary Care Physician data output within the provider information system.
  • Research information on members/subscribers to resolve problems and disputes.
  • Maintains quality and production standards as outlined by government regulations and department policies & procedures.
  • Completion of volumes in queue within specified Turn Around Time.
  • Ability to meet their required production and Quality target.
  • Setting productivity /Quality benchmark
  • Handles internal and external inquiries concerning billing, enrollment of member or subscriber.

Required Skills:

  • Ability to work regularly scheduled shifts from Sunday - Saturday 5 PM IST time to 8 AM IST (5 days working).
  • University degree or equivalent that required 3+ years of formal studies.
  • Work from Office.
  • No transport facility (Own transport).
  • Ability to work in a team environment.
  • Good logical thinking ability.
  • Good English Comprehension/written skills should have exposure to MS Office.
  • Good Communication Skills - Both Verbal and Written
  • Ability to interact with clients preferred.

** Schedule availability for this position is Sunday - Saturday 5 PM IST time to 8 AM IST. The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime, holiday working and weekend working as per business requirement.

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