Healthcare Senior Representative

3 weeks ago

Manila, National Capital Region, Philippines NTT DATA SERVICES PHILIPPINES INC. Full time

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

NTT DATA, Inc. currently seeks Call Center Senior Representative to join our team in Eastwood, Quezon City.

In this role you will be responsible for:

Communicate with contracted and non-contracted Providers by providing information and assistance as appropriate.Assist Providers with interpreting Member eligibility and benefit informationAssist with general question about the existing Programs and Member benefits.Assist with direction on the available Provider portal, including how to set up accounts, troubleshooting and navigating the website, how to submit and retrieve necessary information.Handle claim status inquiries, researching and facilitating resolution of payment issues; provider education on remittance advice interpretation and reimbursement, and informing providers of the claims appeals process.Work closely with the Claims Team in resolving claims discrepancies, inappropriate denials and delays in payments.Provide providers with eligibility; process authorizations and Exception RequestsAnswer questions regarding authorizations and denialsMeet NTT Call Center Standard Work and performance expectations. This includes, but is not limited to the following:Successful completion of Provider Call Center trainingActive participation in continuous trainingFollow required call scripts and QA requirements.Ability to handle high call volume.Provide excellent customer service to all callers. Demonstrate a high level of patience and respect with every caller, ensuring each caller is assisted promptly and appropriately and follow Provider Call Center established call handle Quality Assurance Standards and Objectives.Assist the Provider Call Center or Provider Services Departments with projects, as needed.Timely follow up with Providers on cases as needed.Ensure the privacy and security of PHI (Protected Health Information) as outlined policies and procedures relating to HIPAA compliance. Key Skills: Excellent customer service skills, including ability to diffuse difficult situations.Ability to analyze complex claims data/payments and clearly communicate findings to ProvidersUniversity degree or equivalent that required formal studies of the English language Requirements: Amenable to work in Eastwood, Quezon City (Monday - Friday)
*** The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend's basis business requirement.*** All new hires will be required to successfully complete our Orientation/Process training classes and demonstrate proficiency of the material

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