HC & Insurance Operations Senior Assoc

4 days ago

Chennai, Tamil Nadu, India NTT DATA North America Full time ₹ 5,00,000 - ₹ 12,00,000 per year

Role Responsibilities
:

  • In-depth knowledge and experience in the US healthcare (Non Voice) – Provider Data Validation and Provider Data management.
  • Candidate should have 3 years and above experience in US healthcare and into provider enrollment and credentialling.
  • Ensures day-day transactions are processed per standard operating procedures.
  • Follows Work process flow to ensure pends are completed and maintain Quality and timeliness standards.
  • Knowledge in Amisys and Cenprov application are preferred.
  • Product knowledge in checking affiliation for Medicaid, Medicare and Exchange.
  • Everyday checked Contract information in Payment Index such as, Pay class, override key, accepts code and etc.
  • Ability to read and understand the provider contract.
  • Handling Paid claims and recouped claims.
  • Claims Rejections handling.
  • Working in claims denial management.
  • Knowledge about End to End provider billing process.
  • Working knowledge in EDI rejection claims
  • Handing Patient and provider demographic changes.

Required Skills
:

  • 3 to 5 years of experience in US healthcare working with Provider Data Enrollment and Management.
  • Ability to work in a 24/5 environment; shifts can be rotational .
  • University degree or equivalent that required 3+ years of formal studies.
  • 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.

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