Hc And Insurance Operations Senior Assoc. Job at NTT DATA (Chennai)

Job Description

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. NTT DATA Services currently seeks a "HC & Insurance Operations Senior Assoc." to join our team in "CHENNAI". Analyst will process and review Provider Data Management and Provider Data Enrollment Resources to the Client main application according to its policies and procedures defined.

Job Responsibility

Process and review Provider Data Management and Provider Data Enrollment Resources to the Client main application according to its policies and procedures defined
In-depth knowledge and experience in the US healthcare (Non Voice) – Provider Data Validation and Provider Data management
Ability to train the team on new process and process updates
Calibrate with QA’s to ensure process knowledge and variance are managed and under control
Ability to create Process SOP, Process Map and identifying the outlier within process
Review Discrepancy report and comments, identify gaps and share with TL
Identify NVA and provide suggestion for automation opportunities
Leads teams to manage day to day inventory
Monitors QA scores of production resources and performs reviews to improve overall performance
Floor support to operations and 1st point of level of escalation to client in process, inventory, and performance metrics
Identify refresher/re-trainable topics, conduct assessments, and certify staff to move to different levels of production
Drive team from the front in case of leadership unavailability
Need to co-ordinate with quality team to identify the root cause and provide appropriate solution to overcome errors
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

Requirements

3+ 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 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
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Hc And Insurance Operations Senior Assoc.

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