Job
Description
As a HC & INSURANCE OPERATIONS ANALYST at NTT DATA, your role involves processing and reviewing Provider Data Management and Provider Data Enrollment Resources to the Client main application as per defined policies and procedures. Your responsibilities include: - Demonstrating in-depth knowledge and experience in US healthcare (Non Voice) Provider Data Validation and Provider Data management. - Training the team on new processes and process updates. - Collaborating with QAs to manage process knowledge and variances effectively. - Creating Process SOP, Process Map, and identifying outliers within the process. - Reviewing Discrepancy report, identifying gaps, and sharing with TL. - Identifying Non-Value Added (NVA) tasks and suggesting automation opportunities. - Leading teams to manage daily inventory and monitoring QA scores to enhance overall performance. - Providing floor support to operations and acting as the 1st point of escalation to clients for process, inventory, and performance metrics. - Identifying topics for refresher/re-training, conducting assessments, and certifying staff for production level transitions. - Driving the team in the absence of leadership. - Coordinating with the quality team to identify root causes and provide solutions to overcome errors. - Ensuring day-to-day transactions are processed per standard operating procedures. - Following work process flow to complete pends and maintain Quality and timeliness standards. - Having knowledge in Amisys and Cenprov applications, and product knowledge in checking affiliation for Medicaid, Medicare, and Exchange. - Understanding provider contracts, handling Paid claims, recouped claims, Claims Rejections, claims denial management, and End to End provider billing process. - Working knowledge in EDI rejection claims and handling Patient and provider demographic changes. Required Skills: - 5+ years of experience in US healthcare working with Provider Data Management. - Ability to work regularly scheduled shifts from Monday-Friday 20:30pm to 5:30am IST. - University degree or equivalent with 3+ years of formal studies. - Ability to work in a team environment. - Good logical thinking ability. - Good English Comprehension/written skills with exposure to MS Office. - Good Communication Skills - Both Verbal and Written. - Ability to interact with clients preferred. - Own Transport. Please note that the required schedule availability for this position is Monday-Friday 6PM/4AM IST. Shift timings can be modified as per client requirements, and there may be overtime and weekend work based on business needs. As a HC & INSURANCE OPERATIONS ANALYST at NTT DATA, your role involves processing and reviewing Provider Data Management and Provider Data Enrollment Resources to the Client main application as per defined policies and procedures. Your responsibilities include: - Demonstrating in-depth knowledge and experience in US healthcare (Non Voice) Provider Data Validation and Provider Data management. - Training the team on new processes and process updates. - Collaborating with QAs to manage process knowledge and variances effectively. - Creating Process SOP, Process Map, and identifying outliers within the process. - Reviewing Discrepancy report, identifying gaps, and sharing with TL. - Identifying Non-Value Added (NVA) tasks and suggesting automation opportunities. - Leading teams to manage daily inventory and monitoring QA scores to enhance overall performance. - Providing floor support to operations and acting as the 1st point of escalation to clients for process, inventory, and performance metrics. - Identifying topics for refresher/re-training, conducting assessments, and certifying staff for production level transitions. - Driving the team in the absence of leadership. - Coordinating with the quality team to identify root causes and provide solutions to overcome errors. - Ensuring day-to-day transactions are processed per standard operating procedures. - Following work process flow to complete pends and maintain Quality and timeliness standards. - Having knowledge in Amisys and Cenprov applications, and product knowledge in checking affiliation for Medicaid, Medicare, and Exchange. - Understanding provider contracts, handling Paid claims, recouped claims, Claims Rejections, claims denial management, and End to End provider billing process. - Working knowledge in EDI rejection claims and handling Patient and provider demographic changes. Required Skills: - 5+ years of experience in US healthcare working with Provider Data Management. - Ability to work regularly scheduled shifts from Monday-Friday 20:30pm to 5:30am IST. - University degree or equivalent with 3+ years of formal studies. - Ability to work in a team environment. - Good logical thinking ability. - Good English Comprehension/written skills with exposure to MS Office. - Good Communication Skills - Both Verbal and Written. - Ability to interact with clients preferred. - Own Transport.
