HC & Insurance Operations Senior Rep

PROVIDER DATA MANAGEMENT - GRADE 5

HC & INSURANCE OPERATIONS SENIOR ASSOCIATE

Position Overview :

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 ASSOCIATE ' to join our team in ' CHENNAI'

Position General Duties :

Associate will process and update Provider Data Management and Provider Data Enrollment Resources to the Client's main application according to its policies and procedures defined.

Role Responsibilities :

• In-depth knowledge and experience in the US healthcare (Non Voice) – Provider Data Validation and Provider Data management.
• Candidate should have 5 years and above experience in US healthcare and into provider enrollment and credentialling.
• 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.

Required Skills :

Skills Required

medicare, Exchange, medicaid, Ms Office