HC & INSURANCE OPERATIONS ASSOC

HC & INSURANCE OPERATIONS ASSOC

NTT DATA Global Delivery Services Limited
Coimbatore
3 - 6 Years
Not Specified

Job Description


Job Description :
Req ID:94728
NTT DATA Services strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.
We are currently seeking a HC & INSURANCE OPERATIONS ASSOC to join our team in Coimbatore, Tamil Ndu (IN-TN), India (IN).
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 to3 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 to3 years of experience processing claims that required a working knowledge of HCPCS, ICD and CPT codes
•2 to3 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 5.30pm to 3.40 am IST (AR Shift).
About NTT DATA Services
NTT DATA Services is a global business and IT services provider specializing in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. We are part of the NTT family of companies, a partner to 85 % of the Fortune 100.
NTT DATA Services is an equal opportunity employer and will consider all qualified applicants for employment without regard to race, gender, disability, age, veteran-status, sexual orientation, gender identity, or any other class protected by law.

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