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HC& Claims Insurance Operations Associate BPO

2.00 to 3.00 Years   Coimbatore   06 Nov, 2020
NTT Global Delivery Services Limited
Job LocationCoimbatore
EducationNot Mentioned
SalaryNot Disclosed
IndustryIT - Software
Functional AreaOperations Management / Process Analysis
EmploymentTypeFull-time

Job Description

Req ID:104704 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& Claims Insurance Operations Associate BPO to join our team in Coimbatore, Tamil N du (IN-TN), India (IN).In this Role you will be Responsible For

  • Review and process insurance claims.
  • Validate Member, Provider and other Claims 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 tea
  • 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
  • 2 to 3 Years of experience in Claims Adjudication/Adjustments that required a working knowledge of HCPCS, ICD and CPT codes.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.Experience in Claims Platform AMISYS or Xcelys is preferrable
**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.About NTT DATA ServicesNTT 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.Job Segment: Consulting, Technology ,

Keyskills :
englishinsurance operationsamisysdata servicesicdcptenglish languagecloudclaimsit servicesbusinessbenefitsbpoquality standardsbasicbusiness processmedical

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