Senior Healthcare and Insurance Operations Representative

HC & Insurance Operations Senior Rep.

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 are key factors in our company’s 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 and for the people who work here.

Client’s Business problem to solve?

NTT are getting into contract with Client to manage End to End Claims Administration services. Our NTT Business Process Outsourcing (BPO) team has implemented the processes and technologies for our clients bring about real transformation for customers of all sizes. Our end-to-end administrative services help streamline operations, improve productivity and strengthen cash flow to help our customers stay competitive and improve member satisfaction.

Position’s General Duties and Tasks:

In this role you will be responsible for:

 

Life Claims:

• Processing Death Claims and identifying the right beneficiary(s) to provide the Claims benefit
• Setting up a claim and then following up for pending requirements (if any)
• Examining the received documents, payment calculation and settlement
• Perform additional review before cutting the check

 

Health Claims:

• Supporting different set of Health Claims products which includes Wellness, Critical Illness, Accident, Cancer, HI etc.
• Check the eligibility of the members product wise who will undergo different set of medical examination proceeding with additional care/treatment
• To perform adjudication which will cover the additional review of the medical history proceeding with medical benefits

Requirements for this role include:

• 0 -1 Year of experience in any Healthcare BPO
• University degree or equivalent that required 3+ years of formal studies
• 1+ year(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
• Ability to work scheduled shifts from Monday-Friday 06:00 PM to 04:00 AM and to be flexible to accommodate business requirements 
• Ability to communicate (oral/written) effectively in English to exchange information with our client.

Experience Level

Senior Level