HC & INSURANCE OPERATIONS ASSOCIATE
NTT DATA Services
Gurgaon, HR, IN
23h ago

Req ID : 93731

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 Associate to join our team in Gurgaon , Haryana , India .

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 :

  • 1 to 2 years of Claims Adjudication experience that required you to review claims rules and workflows.
  • 1 to 2 years of experience processing claims that required a working knowledge of HCPCS, ICD and CPT codes
  • 1 to 2 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).

    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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