• Temp BPO Analyst

    NTT DATA North America (Houston, TX)


    Responsibilities:

    Complete PIX and Pay case work assigning payclasses to PIX for provider configuration.

     

    Complete Protivity reviews to validate claim pricing accuracy for all claims that the Protivity system flags as an issue.

     

    Research provider configuration issues to resolve claim pends for the pricing pend team.

     

    Research configuration, claims pricing issues etc for all standard HP relations tickets.

     

    PDI validations.

     

    Attend weekly/monthly meetings with the health plan and the health plan relations teams to identify priority inventory and to resolve outstanding issues.

     

    Create payclass guides for standard payclasses, as well as standard payclass updates and submit CRs to the config team to completion.

     

    Submit BOT updates to have providers loaded to already created payclass rate tables.

    Required Experience:

    Amisys knowledge.

     

    Contract review and previous experience with payment index.

    Preferred Experience:

    Pricing and claims experience

    Software Skills:

    Amisys

     

    Excel

     

    MS Office

     

    Smartsheet

    DST

    Optum (Preferred experience)

    Performance Expectations:

    Meet SLA to coincide with Standard or Custom work as needed. (5 or less days = standard; 15 or less days = custom

     

    Meet standard quality metrics

    Shift Hours:

    Working Hours: 8:00am – 5:00pm CST

     

    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.