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NTT DATA, Inc.
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US Healthcare - Claims Adjudication - Chennai

US Healthcare - Claims Adjudication - Chennai

NTT DATA, Inc.

1 - 3 years

2 - 3 Lacs

Chennai

Posted:1 week ago| Platform:

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Skills Required

Claims Adjudication Health Claims Insurance Claims Medicare CPT HIPAA ICD Cpt Coding US Healthcare Medicaid Medical Billing Medical Terminology

Work Mode

Work from Office

Job Type

Full Time

Job Description

Job Details:

Job Process/Role:

Experience:

Skillset:

Shift:

Location:

Mode of Work:

Notice Period Eligible:

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.

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