HC and Insurance Operations Associate

Role Overview NTT DATA North America is looking for a detail-oriented HC and Insurance Operations Associate to join its healthcare operations team in Chennai. In this full-time role, you will be responsible for processing and adjudicating health insurance claims accurately while ensuring all transactions meet defined client SLA targets. This is an excellent opportunity for candidates with a background in US healthcare claims processing who are looking to grow within a global IT services organization. Key Responsibilities - Process claims adjudication and resolve cases for payment outcomes and denials - Handle authorization requests, coordination of benefits, duplicate claims, pricing queries, and corrected claims workflows - Apply working knowledge of healthcare insurance concepts such as in-network and out-of-network providers, deductibles, coinsurance, co-pay, out-of-pocket maximums, benefit limits, exclusions, and state-level variations - Ensure accurate and timely completion of all transactions to consistently meet or exceed client SLA expectations - Organize and prioritize tasks effectively based on assigned deadlines and business requirements - Continuously develop and maintain a strong understanding of the healthcare insurance industry, including all products, services, and team processes - Resolve complex claims situations by following pre-established operational guidelines Required Qualifications - 1 to 3 years of hands-on experience in claims adjudication and adjustment processing - Familiarity with Facets claims processing system is an added advantage - Exposure to professional claims (HCFA) and institutional claims (UB) is preferred but optional - Open to both undergraduate and postgraduate candidates - Strong reading comprehension and written communication skills - Ability to work independently with sound analytical thinking - Availability to work Monday to Friday in the AR shift (5:30 PM to 3:30 AM IST); shift timings may be adjusted based on client needs; overtime and weekend work may be required Why Join Us NTT DATA North America is a globally recognized technology and business solutions company offering a collaborative and growth-driven work environment. Joining this team means working on impactful US healthcare operations projects with access to continuous learning and professional development opportunities.

- 1 to 3 years of experience in claims adjudication and adjustment processing - Knowledge of authorization, COB, duplicate claims, pricing, and corrected claims handling - Understanding of healthcare insurance concepts including deductibles, coinsurance, co-pay, and benefit limits - Experience with Facets claims system is a plus - Exposure to HCFA and UB claims is preferred - Strong written and verbal communication skills - Ability to work independently with strong analytical skills - Availability for Monday to Friday AR night shift (5:30 PM to 3:30 AM IST) - Undergraduate or postgraduate degree in any discipline

- Full-time permanent employment - Opportunity to work with a global IT and business services leader - Exposure to US healthcare insurance domain - Professional growth and skill development