HC & INSURANCE OPERATIONS ASSOCIATE

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]].

Job Location : Noida

Designation : HC & Insurance Operations Associate

Looking for a Graduate with 1+years of experience in US Health Care (Claim Adjudication)

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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