Healthcare QNXT
WHY eLL.
Over 1000+ professionals trained across different countries
Trusted by people across IT Industry as their learning provider for career growth and training.
We have a young and dynamic team, including research scholars, industry personals and experts in different IT technologies, involved in providing quality education.
Our curriculum is in sync with the international standards and will be maintained to include the rapid changes in technologies.
Role-Specific Training.
Different mode of training as per your inconvenience: Traditional Class room, Instructor Led Online and Self Learning.
We follow a Global Learning Framework which has proven to deliver results and has been perfected by our experience in training a million learners.
Our different modes of training includes traditional classroom training, online training and self learning gives you the best and assists different learning needs and styles.
Free access to high quality industry-relevant videos, articles, blogs and other study material
24×7 live support via chat, mail and phone with a request to call back option
Real-time / latest Projects and Assignments.
KEY FEATURES.
1. 15+ Hrs of live sessions on Claims module
2. Video access of all the sessions
3. Resume and Interview preparation.
ELIGIBILITY.
Anyone having a general understanding of financial accounting terms can opt for SAP FICO certification. This course is suitable for:
Healthcare IT domain knowledge.
Students with a Bachelor or Master’s degree
Executives and Managers
IT/Business analysts and System Analysts
Quality Assurance professionals
Project team members
CURRICULUM
Claims
- Introduction of Healthcare
- Building block of Healthcare
- Claims Module
- Definition of Insurance Claim
- Claim generation
- Claims Models Healthcare claims overview – Institutional,Professional, Dental and Pharmacy
- Types of Claims
- Health Insurance claims process – Adjudication (Acceptance, Denials, Rejections, others)
- Claim Submission
- Claims Intake process
- Claims Adjudication
- Claims Payment Header Details Line level Details
Benefit Module
- Overview of Benefit
- Benefit Plan Module
- Creating New Benefit
- Adding exclusions
- Adding Service Groups
- Adding EOB/Remit Messages
- Managing Restriction Groups
- Managing Accumulators
- Managing codes(CPT,REV)
- Managing Copay
- Managing Diagnosis codes(ICD- 9,ICD10)
Provider Module
- Definition
- ER Diagram
- Provider Search
- Adding a Provider
- Affiliations- Definition and Types
- Affiliates
- Affiliations Tab overview
- Add an attribute
- Edit and Delete attribute
- Managing Contract affiliations
- Participation status
- Managing Plan affiliations
- Service Groups
- Adding a service group
- Specialty
- Adding a specialty
- Memos and Alert
- Finance
- Member Counts
- Cap Adjustments
TRIZETTO®, FACETS™, and QNXT™ are trademarks owned by TriZetto Corporation. This training is not affiliated with TriZetto and TriZetto neither sponsors nor endorses our materials, goods, or services.
This course is designed as per the industry best practices. At the end of the course you will be awarded with Elearningline Course Completion certificate for Healthcare.
Trainers Details
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Online Class schedule (EST)
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