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BPO HC & Insurance Operations Senior Representative

1.00 to 5.00 Years   Coimbatore   14 Sep, 2021
NTT Global Delivery Services Limited
Job LocationCoimbatore
EducationNot Mentioned
SalaryNot Disclosed
IndustryIT - Software
Functional AreaSales / BD
EmploymentTypeFull-time

Job Description

Positions General Duties and TasksIn these roles you will be responsible for:

  • Review and process insurance claims.
  • Validate Member, Provider and other Claim s information.
  • Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
  • Coordination of Claim Benefits based on the Policy & Procedure.
  • Maintain productivity goals, quality standards and aging timeframes.
  • Scrutinizing Medical Claim Documents and settlements.
  • Organizing and completing tasks per 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 for this role include:
  • University degree or equivalent that required formal studies of the English language and basic Math
  • 6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions
  • 6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
  • 6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
  • 6+ months of experience that required prioritizing your workload to meet deadlines
Preferences: - Optional (nice-to-have s)
  • Ability to communicate (oral/written) effectively to exchange information with our client.
Required schedule availability for this position is Monday-Friday (06:00pm to 04:00am IST). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend s basis business requirement.Job Segment: Data Entry, Administrative ,

Keyskills :
data entrybenefitsmarketingaccrualsclaimsenglishquality standardsbasicscreenssoftwarebusiness rulesfactbusinesscustomer relationsexchangewindowsenglish languageequitiessecuritiesmedical

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