HC & Insurance Operations Senior Assoc.

PROVIDER DATA MANAGEMENT - GRADE 5

HC & INSURANCE OPERATIONS SENIOR ASSOCIATE

Position Overview

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

HC & INSURANCE OPERATIONS SENIOR ASSOCIATE

Position General Duties:

Associate will process and update Provider Data Management and Provider Data Enrollment Resources to the Client's main application according to its policies and procedures defined.

Role Responsibilities

• In-depth knowledge and experience in the US healthcare (Non Voice) - Provider Data Validation and Provider Data management.
• Candidate should have 5 years and above experience in US healthcare and into provider enrollment and credentialling.
• Ensures day-day transactions are processed per standard operating procedures.
• Follows Work process flow to ensure pends are completed and maintain Quality and timeliness standards.
• Knowledge in Amisys and Cenprov application are preferred.
• Product knowledge in checking affiliation for Medicaid, Medicare and Exchange.
• Everyday checked Contract information in Payment Index such as, Pay class, override key, accepts code and etc.
• Ability to read and understand the provider contract.
• Handling Paid claims and recouped claims.
• Claims Rejections handling.
• Working in claims denial management.
• Knowledge about End to End provider billing process.
• Working knowledge in EDI rejection claims
• Handing Patient and provider demographic changes.

Required Skills

• 3 to 5 years of experience in US healthcare working with Provider Data Enrollment and Management.
• Ability to work in a 24/5 environment shifts can be rotational.
• University degree or equivalent that required 3+ years of formal studies.
• Ability to work in a team environment.
• Good logical thinking ability.
• Good English Comprehension/written skills should have exposure to MS Office.
• Good Communication Skills - Both Verbal and Written
• Ability to interact with clients preferred.

..Required schedule availability for this position is 24/5 and the shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend's basis business requirement.