US Healthcare - Claims Adjudication - Chennai
- NTT DATA, Inc.
- 1 - 3 years
- Chennai
- 5 months ago
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Job Description
Job Details:
Job Process/Role: Claims Adjudication (US Healthcare)
Experience: 1 - 3 Years of Relevant experience in Claims adjudication
Skillset: CPT Codes, HIPAA, Co-pay and Co-insurance, Medicaid and Medicare, Denial claims, UB and CMS forms.
Shift: Night shift
Location: Chennai
Mode of Work: Work from the office
Notice Period Eligible: Immediate to 30 Days of Notice period is acceptable.
Roles and Responsibilities:
- Process Adjudication claims and resolve for payment and Denials.
- Knowledge in handling authorization, COB, duplicate, pricing, and the corrected claims process.
- 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.
- 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:
- 1-3 years of experience in processing claims adjudication, and the adjustment process.
- Experience in professional (HCFA), institutional (UB) claims (optional).
- Both undergraduates and postgraduates can apply.
- Good communication (Demonstrate strong reading comprehension and writing skills).
- Able to work independently, with strong analytical skills.
1. Required schedule availability for this position is Monday-Friday, 5.30 PM/3.30 AM IST (AR SHIFT). The shift timings can be adjusted according to client requirements.
2. Additionally, resources may have to work overtime and on a weekend basis to meet business requirements.
Job Classification
Industry: BPM / BPOFunctional Area / Department: Customer Success, Service & OperationsRole Category: Non VoiceRole: Non Voice - OtherEmployement Type: Full timeContact Details:
Company: NTT DATA, Inc.Location(s): Chennai
Keyskills: Claims Adjudication Health Claims Insurance Claims Medicare CPT HIPAA ICD Cpt Coding US Healthcare Medicaid Medical Billing Medical Terminology
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