Vacancy expired!
Our Client is one of Leading Health Plan in US providing services in Florida Tampa state , NTT are getting into contract with Client for Manual adjudication and Adjustment process. 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.In this Role you will be Responsible for :" Reviewing and researching insurance claims to determine possible payment accuracy." Validating Member, Provider and other Claims information." Determining accurate payment criteria for clearing pending claims based on defined Policy and Procedure." Coordinating Claim Benefits based on the Policy & Procedure." Maintaining productivity goals, quality standards and aging timeframes." Scrutinizing Medical Claim Documents and settlements.Requirements for this role include :" 1 + years of Claims Adjudication experience that required you to review claims rules and workflows." 1+ years of experience processing claims that required a working knowledge of HCPCS, ICD and CPT codes" 1+ years of experience that required a knowledge of healthcare insurance policy concepts including In Network, Out of Network providers, Deductible, Coinsurance, Co-pay, Out of Pocket, Maximum inside limits and Exclusions, State Variations." Regular working hours from 8:00 am to 5:00 pm (EST) unless an until we have exceptioinal approval from Managment for the extension." Prior experience with Xcelys and/or Amisys software system(s)This position is 100% remote
Vacancy expired!