Hiring For Claims Adjudication Role - Gurugram
- NTT DATA
- 1 - 3 years
- Noida, Gurugram
- 4 years ago
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Job Description
Roles and Responsibilities
In this Role you will be Responsible For :
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
Requirements for this role include:
1.5 to 3 years of experience in a BPO handling Healthcare adjudication process in CPS claims platform.
University degree or equivalent that required 3+ years of formal studies is a must to apply
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.
Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM
Interested candidates can share your resume along with below details to Sa*****************h@nt****a.com
Total Experience:
Relevant Experience:
Current CTC:
Expected CTC:
Notice Period:
Regards,
Sathish Kumar
NTT Data HR Team
Job Classification
Industry: BPO / Call CentreFunctional Area: Customer Success, Service & Operations, Role Category: Non VoiceRole: Non VoiceEmployement Type: Full timeEducation
Under Graduation: Any GraduatePost Graduation: Post Graduation Not Required, Any PostgraduateDoctorate: Doctorate Not Required, Any DoctorateContact Details:
Company: NTT DataLocation(s): Noida, Gurugram
Keyskills: Claims adjudicator Claims associate Claims Adjudication Claims Processor
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