Claim Adjudicator Associate E-345

Claim Adjudicator Associate E-345

08 Dec
|
NTT Data Vertex Software Inc.
|
Coimbatore district

08 Dec

NTT Data Vertex Software Inc.

Coimbatore district

Job Description

At NTT DATA Services, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our companys growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA Services and for the people who work here.


NTT DATA Services currently seeks a Claim Adjudicator Associate to join our team in Coimbatore, Tamil Ndu (IN-TN), India (IN).


In this Role you will be Responsible For


Experienced level adjudicator providing analytical ability to review claim rules and workflows.






Reviews claim requests to determine eligibility for processing and escalate to management as necessary.
Responsible for the coordination and resolution of the administrative denials and appeals
Ability to understand logic of standard medical coding (i.e. CPT, ICD-10, HCPCS, etc.).
Ability to resolve claims that require adjustments and adjustment projects , Identify claim(s) with inaccurate data or claims that require review by appropriate team members.
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


Requirements for this role include:


University degree or equivalent that required formal studies of the English language and basic Math
1 year(s) of experience processing claims for the US healthcare market
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 6PM/4AM IST The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekends basis business requirement.


This position is only available to those interested in direct staff employment opportunities with NTT DATA, Inc. or its subsidiaries. Please note, 1099 or corp-2-corp contractors or the equivalent will NOT be considered. We offer a full comprehensive benefits package that starts from your first day of employment.


About NTT DATA Services


NTT DATA Services partners with clients to navigate and simplify the modern complexities of business and technology, delivering the insights, solutions and outcomes that matter most. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services.


NTT DATA Services, headquartered in Plano, Texas, is a division of NTT DATA Corporation, a top 10 global business and IT services provider with 118,000 professionals in more than 50 countries, and NTT Group, a partner to 88 percent of the Fortune 100. Visit nttdataservices.com to learn more.


NTT DATA, Inc. (the Company) is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other class protected by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.


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