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HC & Insurance Operations Associate

1.00 to 4.00 Years   Coimbatore   21 Oct, 2019
NTT Global Delivery Services Limited
Job LocationCoimbatore
EducationNot Mentioned
SalaryNot Disclosed
IndustryIT - Software
Functional AreaOperations Management / Process Analysis
EmploymentTypeFull-time

Job Description

NTT DATA Services currently seeks a HC Insurance Operations Associate to join our team in Coimbatore , Tamil N du (IN-TN) , India (IN) .

  • Experienced level adjudicator providing analytical ability to review claim rules and workflows.
  • Reviews claim requests to determine eligibility for processing and escalate to management as necessary.
  • Responsible for the coordination and resolution of the administrative denials and appeals
  • Ability to understand logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.).
  • Ability to resolve claims that require adjustments and adjustment projects , Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
  • 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
  • 1 year(s) of experience processing claims for the US healthcare market
  • 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
**Required schedule availability for this position is Monday-Friday 6PM/4AM 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: Consulting, Cloud, Data Entry, Technology, Administrative,

Keyskills :
claims fact windows medical cloud appeals nsuranceoperations ushealthcare dataentry analyticalability medicalcoding businessrules dataservices

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