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HC & Insurance Operations Analyst

3.00 to 4.00 Years   Coimbatore   10 May, 2022
NTT Global Delivery Services Limited
Job LocationCoimbatore
EducationNot Mentioned
SalaryNot Disclosed
IndustryIT - Software
Functional AreaIT Operations / EDP / MIS
EmploymentTypeFull-time

Job Description

    In this Role you will be Responsible for : Support team members in day to day operations but not limited to: Reviewing and researching insurance claims in all aspects to determine possible payment accuracy Reviewing errors charged by internal/external auditors and submit possible rebuttals to audit team Providing feedback and coaching/refresher to defaulters basis errors charged Identifying training needs for bottom performers and lay out a plan to improve their performance Develop and manage reporting standards across team Create and maintain reports to track progress of team and submit to management on regular basis Manage the communication across team i.e., change in processing guidelines Imparts process training for new team members and work as a mentor for them Requirements for this role include : 3+ years of Claims Adjudication experience that required you to review claims rules and workflows. 3+ years of experience processing claims that required a working knowledge of HCPCS, ICD and CPT codes 3+ 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. Align to USA business hours and USA Holiday schedule Desired Skills: Prior experience with Amisys software system(s) Good communication skills (these SME s will liaise and work with onshore Analyst, Trainers & Sups) Eye for details, broader outlook and ability to look at E2E process to identify gaps and solutions Medicaid Business Knowledge Align to USA business work hours and follow USA holiday calendar ,

Keyskills :
claims adjudicationreportinginsurance claimstraining needsslaprocess trainingaccountscustomer relations

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