Client's business problem to solve?

Our Client is one of the leading Health Plans in the US providing services in multiple states. NTT Business Process Outsourcing (BPO) team offers 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

• Process claims by following the policies and procedures as defined by the customer.
• Take up additional trainings/ new assignments or projects that may come up as per client needs.
• Meet/ exceed required performance measures such as quality and productivity standards
• Meet/ exceed process SLAs
• Confirm to the required regulatory and compliance requirements such as the HIPAA.
• Confirm to the organizational and client training requirements
• Understand how work impacts results for their area as well as other processes.
• Demonstrate knowledge of internal operations and develops relationships to facilitate workflow.
• Knowledge of related regulations and standards.
• Strong understanding of current processes and procedures and may identify opportunities for improvement.

• High school Diploma or equivalent.

• 3+ years of claims processing experience in a Health care payer/ BPO/ TPA setting (Claims Examiners)
• 3+ years of Medicaid claims processing experience using Amisys
• 3+ years of processing COB and Dual claims
• 5+ years of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, leverage internet search engines, and other web based applications.
• 5+ years of experience with the Microsoft Office suite that required daily usage of Outlook, Excel and Word.
• Ability to type 40 WPM