Job Description :Req ID:94727NTT 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 cur
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 & Insurance Operations Associate to join our team in Coimbatore, Tamil Ndu (IN-TN),India (IN).
In this Role you will be Responsible For
Reviewing and researching insurance claims to determine possible payment accuracy.
Validating Member, Provider and other Claims information.
Determining accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
Coordinating Claim Benefits based on the Policy & Procedure.
Maintaining productivity goals, quality standards and aging timeframes.
Scrutinizing Medical Claim Documents and settlements
Requirements For This Role Include
2 to 3 years of Claims Adjudication experience that required you to review claims rules and workflows.
Experience in audit process is preferrable.
Experience in Claims Platform AMISYS or Xcelys is preferrable
2 to3 years of experience processing claims that required a working knowledge of HCPCS, ICD and CPT codes
2 to3 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.
Ability to communicate (oral/written) effectively in English to exchange information with our client.
Required schedule availability for this position is Monday-Friday 5.30pm to 3.40 am IST (AR Shift).