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HC & Insurance Operations Associate

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NTT DATA

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Location:
India , Coimbatore

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Category:
Customer Service

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

The Healthcare & Insurance Operations Associate will be responsible for processing claims adjudication and resolving payment denials. The role requires a solid understanding of healthcare insurance policies and the ability to manage tasks efficiently to meet client SLAs. Candidates should possess strong analytical and communication skills, with a focus on independent work and problem resolution.

Job Responsibility:

  • Process Adjudication claims and resolve for payment and Denials
  • Knowledge in handling authorization, COB, duplicate, pricing and 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 adjustment process
  • Experience of Facets is an added advantage
  • Experience in professional (HCFA), institutional (UB) claims (optional)
  • Both under graduates and post graduates can apply
  • Good communication (Demonstrate strong reading comprehension and writing skills)
  • Able to work independently, strong analytic skills

Nice to have:

  • Experience of Facets
  • Experience in professional (HCFA), institutional (UB) claims

Additional Information:

Job Posted:
May 09, 2026

Employment Type:
Fulltime
Work Type:
On-site work
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