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HC & Insurance Operations Senior Assoc.

1.00 to 3.00 Years   Coimbatore   24 Aug, 2022
NTT Global Delivery Services Limited
Job LocationCoimbatore
EducationNot Mentioned
SalaryNot Disclosed
IndustryIT - Software
Functional AreaOperations Management / Process Analysis
EmploymentTypeFull-time

Job Description

    Roles and Responsibilities:
    • Process Adjudication claims and resolve for payment and Denials
    • Knowledge in handling authorization, COB, duplicate, pricing and corrected claims process
    • 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
    • Ensuring accurate and timely completion of transactions to meet or exceed client SLAs
    • Organizing and completing tasks according to 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:
    • 1-3 years of experience in processing claims adjudication and adjustment process
    • Experience in professional (HCFA), institutional (UB) claims (optional)
    • Both under graduates and post graduates can apply
    • Good communication (Demonstrate strong reading comprehension and writing skills)
    • Able to work independently, strong analytic skills
    **Required schedule availability for this position is Monday-Friday 5.30PM/3.30AM IST (AR SHIFT). 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.,

Keyskills :
businessanalyticsadjudicationscheduleavailabilityclaims adjudication

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