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 claims processing team in Chennai. This role is ideal for professionals with hands-on experience in claims adjudication who can deliver accurate and timely results while consistently meeting client service level agreements. You will be part of a dynamic operations team supporting US-based healthcare insurance workflows in a night shift environment. Key Responsibilities - Process and adjudicate healthcare insurance claims and resolve outcomes including payments and denials - Handle authorization requests, coordination of benefits, duplicate claims, pricing disputes, and corrected claims - Apply working knowledge of healthcare insurance concepts such as in-network and out-of-network providers, deductibles, co-pays, coinsurance, out-of-pocket limits, and policy exclusions - Ensure all transactions are completed accurately and within the timelines required by client SLAs - Organise and prioritise tasks effectively to meet assigned deadlines - Resolve complex claims scenarios by following established operational guidelines - Continuously develop knowledge of healthcare insurance products, services, and team processes Required Qualifications - 1 to 3 years of experience in claims adjudication and adjustment processing - Understanding of professional claims (HCFA) and institutional claims (UB) formats is an advantage - Experience with Facets claims processing software is preferred but not mandatory - Open to both graduates and postgraduates from any discipline - Strong reading comprehension, written communication, and analytical skills - Ability to work independently and handle complex situations with minimal supervision - Availability to work Monday to Friday in the AR Shift (5:30 PM to 3:30 AM IST), with flexibility for overtime and weekend work based on business needs Why Join Us NTT DATA North America is a globally recognised technology and business services organisation that offers meaningful career growth within the healthcare operations space. This is a great opportunity to build deep domain expertise in US healthcare insurance while working with an industry-leading team.

- 1 to 3 years of experience in claims adjudication and adjustment processing - Knowledge of healthcare insurance concepts including deductibles, co-pays, coinsurance, and network providers - Familiarity with COB, duplicate claims, pricing, and corrected claims handling - Experience with professional (HCFA) and institutional (UB) claims is advantageous - Facets software experience is a plus - Strong written and verbal communication skills - Good analytical skills with the ability to work independently - Graduates and postgraduates are eligible to apply - Willingness to work night shift (AR Shift: 5:30 PM to 3:30 AM IST, Monday to Friday) - Flexibility to work overtime and weekends as required

- Opportunity to work with a globally recognised IT and business services company - Exposure to US healthcare insurance domain and processes - Professional growth within a structured operations team - Full-time permanent employment