Hiring For Claims Adjudication

2 days ago

Chennai, Tamil Nadu, India NTT DATA, Inc. Full time ₹ 6,00,000 - ₹ 12,00,000 per year

Roles and Responsibilities:

  • Process Adjudication claims and resolve for payment and Denials
  • Knowledge in handling authorization, COB, duplicate, pricing, and the 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 the adjustment process
  • Experience of Facets is an added advantage.
  • Experience in professional (HCFA), institutional (UB) claims (optional)
  • Both undergraduates and postgraduates can apply
  • Good communication (Demonstrate strong reading comprehension and writing skills)
  • Able to work independently, strong analytical skills

**Required schedule availability for this position is Monday-Friday 5.30 PM/3.30 AM IST (AR SHIFT). The shift timings can be changed as per client requirements. Additionally, resources may have to work overtime and on a weekend basis to meet business requirements.

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