HC and Insurance Operations Associate

Role Overview NTT DATA North America is looking for a skilled HC and Insurance Operations Associate to join its healthcare insurance processing team in Chennai. This role involves handling end-to-end claims adjudication and resolution functions while maintaining high accuracy and adherence to client SLAs. You will work in a structured, process-driven environment supporting US healthcare insurance operations. Key Responsibilities - Process and adjudicate healthcare insurance claims and resolve payment and denial scenarios - Handle authorization, coordination of benefits, duplicate claims, pricing, and corrected claims workflows - Apply knowledge of healthcare insurance concepts such as deductibles, co-pay, coinsurance, in-network and out-of-network providers, out-of-pocket limits, and policy exclusions - Ensure timely and accurate completion of transactions in line with client SLA requirements - Organise and prioritise tasks according to assigned schedules and business needs - Build and maintain a strong working knowledge of healthcare insurance products, services, and team processes - Resolve complex claim scenarios by following pre-established operational guidelines Required Qualifications - One to three years of hands-on experience in claims adjudication and adjustment processing - Familiarity with Facets claims processing platform is a distinct advantage - Exposure to professional HCFA and institutional UB claims is preferred but optional - Graduates and postgraduates from any discipline are welcome to apply - Strong reading comprehension, written communication, and independent analytical skills - Availability to work Monday to Friday in the AR shift from 5:30 PM to 3:30 AM IST, with flexibility for overtime and weekend work as per business requirements Why Join Us NTT DATA is a global leader in IT and business services, offering a stable and growth-oriented work environment for healthcare operations professionals. This is an excellent opportunity to build deep expertise in US healthcare insurance processing with a reputed multinational organisation.

- 1 to 3 years of experience in claims adjudication and adjustment processing - Knowledge of healthcare insurance concepts including deductibles, co-pay, coinsurance, and network benefits - Experience handling authorization, COB, duplicate, pricing, and corrected claims - Familiarity with Facets claims system is an added advantage - Exposure to professional HCFA and institutional UB claims is preferred - Strong written communication and reading comprehension skills - Ability to work independently with solid analytical skills - Graduates and postgraduates from any field are eligible - Willingness to work AR shift timings and overtime as required

- Full-time permanent employment with a global IT leader - Exposure to US healthcare insurance domain - Structured SLA-driven work environment with defined processes - Opportunity to work with a skilled and collaborative operations team