HC & Insurance Operations Senior Rep.

NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.

We are currently seeking a [[HC and INSURANCE OPERATIONS SENIOR REP]] to join our team in [[Coimbatore]], [[Tamil Nadu]], [[India]].

In this Role you will be Responsible For Review and process insurance claims.

Validate Member, Provider and other Claims 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

Requirements for this role include:

University degree or equivalent that required formal studies of the English language and basic Math
6 months+ Year of experience where you had to apply business rules to varying fact situations and make appropriate decisions
6 months+ Year of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
6 Months+ Year 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+ Year 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 weekend s basis business requirement.