HC& Claims Insurance Operations Associate

NTT DATA Services - Coimbatore, Tamil Nadu

NTT DATA Services

NTT 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.

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 Nādu (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 Services

NTT 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.

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