HC & Insurance Operations Senior Assoc.

As a HC & INSURANCE OPERATIONS SENIOR ASSOCIATE at NTT DATA, your primary responsibility will be to process and update Provider Data Management and Provider Data Enrollment Resources in the Clients main application following defined policies and procedures. Your role will involve ensuring day-to-day transactions are processed as per standard operating procedures, completing pends, and maintaining quality and timeliness standards. Additionally, you will need to have in-depth knowledge and experience in US healthcare Provider Data Validation and Management, specifically in provider enrollment and credentialing. Key Responsibilities: - Possessing 5 years or more experience in US healthcare, with a focus on Provider Data Enrollment and Management - Demonstrating knowledge in Amisys and Cenprov applications - Conducting product checks for affiliation with Medicaid, Medicare, and Exchange - Reading and understanding provider contracts - Handling Paid claims, recouped claims, claims rejections, and claims denial management - Understanding the End-to-End provider billing process - Working with EDI rejection claims and managing patient and provider demographic changes Qualifications Required: - 3 to 5 years of experience in US healthcare related to Provider Data Enrollment and Management - Ability to work in a 24/5 environment with rotational shifts - University degree or equivalent with 3+ years of formal studies - Strong teamwork, logical thinking, and English comprehension/written skills - Proficiency in MS Office applications - Effective communication skills both verbally and in writing - Capability to interact with clients is preferred Please note that the required schedule availability for this position is 24/5, and shift timings may be adjusted based on client requirements. Overtime work and weekend shifts may be necessary as per business needs.,