Claims QA

Responsibilities:Claims Processing Analysis: Conduct comprehensive analysis of claims data to identify trends, anomalies, and opportunities for improvement.Quality Assurance: Execute quality assurance processes to verify the accuracy and completeness of claims submissions and adjudications.Performance Monitoring: Monitor key performance indicators (KPIs)...

Professional SummaryExperienced Power BI Tester with over 10 years of expertise in validating business intelligence solutions within the insurance domain. Specializes in automation testing of Power BI dashboards, DAX expressions, and data pipelines deployed on AWS cloud infrastructure. Ensures accuracy, performance, and reliability of reports used for...

In these roles you will be responsible for: Configuring client System for Pricing (Provider Contract) as per the requirement and according to defined business rules of new claims processing platform. Evaluation of Configuration Requirement and Formulation of Configuration Approach and Effectively include advanced configuration and additional functionality...

 PROVIDER DATA MANAGEMENT - GRADE 5 HC & Insurance Operations Senior Assoc.Position Overview:At NTT DATA, we know that with the right people on board, anything is possible.  The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence.  By hiring the best people and helping them grow both...

 PROVIDER DATA MANAGEMENT - GRADE 6 HC & INSURANCE OPERATIONS ANALYSTPosition Overview:At NTT DATA, we know that with the right people on board, anything is possible.  The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence.  By hiring the best people and helping them grow both...

PROVIDER DATA MANAGEMENT - GRADE 6HC & INSURANCE OPERATIONS ANALYSTPosition Overview:At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and...

Job Title: Lead Radiology Medical CoderYears of Experience: 7 yearsNo of openings: 1Notice period: Immediate to 15daysWork from Office Location: Chennai GuindyJob Title: Radiology Denials CoderJob Summary The Radiology Denials Coder is responsible for reviewing, analyzing, and resolving claim denials related to radiology services. This role ensures accurate...

We are looking for a highly experiencedSenior Business Analystto drive business analysis activities for the Life Admin modules of our insurance administration platform. This role requires deep domain expertise ininsurance or reinsurance, strong analytical capabilities, and the ability to leverageGenAI toolingto accelerate backlog authoring, documentation,...

We are seeking an experiencedLead Business Analystwith extensive expertise in the Healthcare Payer domain to join our team as an SME.This role will be pivotal in understanding business needs, offering tailored solutions, and ensuring project success while adhering to industry standards and regulations.ResponsibilitiesAct as a trusted SME for Healthcare Payer...

Overview: Certified CPC/CCS coder with minimum 3 years of post-certification experience, experience and skillset, to review the medical records and determine the coding corrections. E&M Coders. ;Qualifications:CPC/CCS Certified Coder with minimum 3 years of experience after certification.Credential should not have Apprentice (CPC-"A").Should have experience...