Hc & Insurance Operations Processing Sr Rep Job at NTT DATA (Plano)

HC & Insurance Operations Processing Sr Rep

Our Client is one of Leading Health Plan in US providing services in Florida sta...

Location

United States , Plano

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

University degree or equivalent that required formal studies of the English language and basic Math
6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions
6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product
6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
6+ months of experience that required prioritizing your workload to meet deadlines

Job Responsibility

Review and process insurance claims
Validate Member, Provider and other Claim’s information
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure
Coordination of Claim Benefits based on the Policy & Procedure
Maintain productivity goals, quality standards and aging timeframes
Scrutinizing Medical Claim Documents and settlements
Organizing and completing tasks per 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

Fulltime

Hc & Insurance Operations Processing Sr Rep

Our Client is one of Leading Health Plan in US providing services in Florida sta...

Location

United States , Plano

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

University degree or equivalent that required formal studies of the English language and basic Math
6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions
6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product
6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
6+ months of experience that required prioritizing your workload to meet deadlines
Required schedule availability for this position is Monday-Friday (06:00pm to 04:00am IST)

Job Responsibility

Review and process insurance claims
Validate Member, Provider and other Claim’s information
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure
Coordination of Claim Benefits based on the Policy & Procedure
Maintain productivity goals, quality standards and aging timeframes
Scrutinizing Medical Claim Documents and settlements
Organizing and completing tasks per 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

Fulltime

Hc & Insurance Operations Processing Sr Rep

At NTT DATA, we know that with the right people on board, anything is possible. ...

Location

United States , Plano

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

University degree or equivalent that required formal studies of the English language and basic Math
6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions
6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product
6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
6+ months of experience that required prioritizing your workload to meet deadlines

Job Responsibility

Review and process insurance claims
Validate Member, Provider and other Claim's information
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure
Coordination of Claim Benefits based on the Policy & Procedure
Maintain productivity goals, quality standards and aging timeframes
Scrutinizing Medical Claim Documents and settlements
Organizing and completing tasks per 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

Hc And Insurance Operations Processing Sr Rep

Our Client is one of Leading Health Plan in US providing services in Florida sta...

Location

United States , Plano

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

University degree or equivalent that required formal studies of the English language and basic Math
6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions
6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product
6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
6+ months of experience that required prioritizing your workload to meet deadlines
Required schedule availability for this position is Monday-Friday (06:00pm to 04:00am IST)
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

Job Responsibility

Review and process insurance claims
Validate Member, Provider and other Claim’s information
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure
Coordination of Claim Benefits based on the Policy & Procedure
Maintain productivity goals, quality standards and aging timeframes
Scrutinizing Medical Claim Documents and settlements
Organizing and completing tasks per 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

Fulltime

BPO HC & Insurance Operations Sr Rep

Location

United States , Plano

Salary:

Not provided

NTT DATA

Expiration Date

Until further notice

Requirements

University degree or equivalent that required formal studies of the English language and basic Math
6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions
6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product
6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools
6+ months of experience that required prioritizing your workload to meet deadlines

Job Responsibility

Review and process insurance claims
Validate Member, Provider and other Claim’s information
Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure
Coordination of Claim Benefits based on the Policy & Procedure
Maintain productivity goals, quality standards and aging timeframes
Scrutinizing Medical Claim Documents and settlements
Organizing and completing tasks per 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

Fulltime

New

Branch Manager

Come and join us as a results driven Branch Manager to deliver sales and exceed ...

Location

United Kingdom , Lymington

Salary:

Not provided

City Plumbing

Expiration Date

Until further notice

Requirements

A great positive attitude
Enjoy customer interaction
Management Experience
Safe Practices
Forward Thinking
Tenacity and resilience
A pro-active approach to sales, with a strong desire and ability to win and grow new business
Experience of customer relationship management and developing a true partnership approach
Excellent communication skills
Self confident and self motivated, with the ability to work on own initiative or as part of a wider team

Job Responsibility

Effective management of the team and resource
Setting the standard of a sales orientated culture
Delivering against sales and customer demands while maximising profitability
Maximising margin and net profit
Keeping everyone safe
Build and maintain relationships with new and existing trade and retail customers
Ability to interpret and analyse financial and statistical information

What we offer

Bonus
Discounts, savings and cash back at numerous retailers
Life assurance
Extended family policy including maternity, paternity, additional annual leave and more
Mental Health First Aiders and Employee Assistance Programme, we look out for each other
Complete induction and a company that lets you grow and encourages development
Financial education and loans
Flexible working options
A business striving to create an environment of inclusion so everyone can be their true self

Fulltime

New

Guest Environment Expert

Our jobs aren’t just about giving guests a clean room and a freshly made bed. In...

Location

United States , Poughkeepsie

Salary:

18.00 USD / Hour

Marriott Bonvoy

Expiration Date

Until further notice

Requirements

Ensuring a safe work place
following company policies and procedures
maintaining confidentiality
upholding quality standards
ensuring professional uniform, personal appearance, and communications
ability to stand, sit, or walk for an extended time
ability to move, lift, carry, push, pull, and place objects weighing less than or equal to 50 pounds without assistance

Job Responsibility

Delivering guest requests
stocking carts
cleaning rooms and public spaces
maintaining the appearance and cleanliness of the whole hotel

Parttime

New

Project Engineer

Our client is seeking a motivated and experienced Project Engineer to join their...

Location

United Kingdom , Dartford

Salary:

30000.00 GBP / Year

Office Angels

Expiration Date

Until further notice

Requirements

Proven construction based industry experience, (ideally within Smoke Ventilation/Fire Alarm Systems but not essential)
Computer literate with strong reporting and organisational skills
Excellent interpersonal and communication skills
Ability to multitask and manage cross-disciplinary projects
Strong time management and decision-making abilities
Professional, presentable, and self-motivated
Team-oriented with a commitment to exceeding client and colleague expectations
Full UK Driving License required, ideally with your own transport

Job Responsibility

Assist in the development and delivery of Risk and Method Statements
Compile detailed project reports covering quality, progress, and issues
Measuring up for install jobs and conducting Coordinate on-site deliveries to ensure smooth logistics
Support the accounts team with project-related financials and debt collection
Monitor project costs and provide financial updates, including profit/loss analysis
Communicate effectively with subcontractors and ensure alignment with project goals
Manage resources according to the client's program and track project progress
Ensure all documentation and certification is accurate, complete, and submitted on time

What we offer

23 days annual leave plus bank holidays, rising to 25 days annual leave at 2 years service
Company mobile phone
uniform and PPE
Life Insurance
Private Health Care
Pension Scheme

Fulltime

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Hc & Insurance Operations Processing Sr Rep

Job Description

Job Responsibility

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Hc & Insurance Operations Processing Sr Rep

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