Hiring For Claims (Inquiry) Adjudication @ NTT DATA

Job Description

Roles and Responsibilities

Review & Processes Healthcare payer claims including HCFA & UB forms.
Validate Member, Provider and other Claims information.
Resolve multiple hold codes/edits to complete a transaction
Need to verify and understand the health plan documents to take decision on benefits allowed
Strong knowledge on all claims type like COB, corrected submission etc.
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
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

Desired Candidate Profile

1 to 3 years of experience in a BPO handling Healthcare inquiry/ adjudication process in CPS claims platform.
Should be life science graduates

Ability to communicate (oral/written) effectively in English to exchange information with our client.
1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.

Should be open to work in Night shifts

Interested candidates please share your resume to pr********************n@nt****a.com

Job Classification

Industry: BPO / Call Centre
Functional Area: Healthcare & Life Sciences,
Role Category: Health Informatics
Role: Health Informatics
Employement Type: Full time

Education

Under Graduation: B.Sc in Anthropology, Home Science, Bio-Chemistry, Biology, Microbiology, Botany, Nursing, Chemistry, Zoology
Post Graduation: MS/M.Sc(Science) in Biotechnology, Organic Chemistry, Anthropology, Home science, Bio-Chemistry, Biology, Microbiology, Botany, Nursing, Chemistry
Doctorate: Any Doctorate, Doctorate Not Required

Contact Details:

Company: NTT Data
Address: No.18 18/1,South End Road, BANGALORE, Karnataka, India
Location(s): Chennai

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Keyskills:   Claims inquiry provider credentialing Maintenance Claims Adjudication Provider healthcare Claims Processing