Transaction Quality Assurance Associate - Coimbatore, Tamil Nadu, India - NTT DATA

NTT DATA

Verified Company

Coimbatore, Tamil Nadu, India

4 weeks ago

Posted by:

Deepika Kaur

beBee Recuiter

Description

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, ICD10, 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 preestablished guidelines
Assists with transaction processing and detects errors in transaction.
Performs transactional quality based on audit parameters.
Classifies errors based on the type of the error and assigns root causes for errors.

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 and performed quality audit of claims for the US healthcare market
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 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.