Job Details

Join to apply for the Remote Medical Claims Examiner role at NTT DATA North America

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.

NTT DATA is seeking to hire a Remote (Anywhere in US besides CA) Claims Processing Associate to work for our end client and their team.
NOTE: This is a US based, W-2 project. All candidates will be paid through NTT DATA only.

In this Role the candidate will be responsible for:

• Processing of Professional claim forms files by provider
• Reviewing the policies and benefits
• Comply with company regulations regarding HIPAA, confidentiality, and PHI
• Abide with the timelines to complete compliance training of NTT Data/Client
• Work independently to research, review and act on the claims
• Prioritize work and adjudicate claims as per turnaround time/SLAs
• Ensure claims are adjudicated as per clients defined workflows, guidelines
• Sustaining and meeting the client productivity/quality targets to avoid penalties
• Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
• Timely response and resolution of claims received via emails as priority work
• Correctly calculate claims payable amount using applicable methodology/ fee schedule

Requirements:

• 1-3 year(s) hands-on experience in Healthcare Claims Processing
• 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
• High school diploma or GED.
• Previously performing - in P&Q work environment; work from queue; remotely
• Key board skills and computer familiarity -
  • Toggling back and forth between screens/can you navigate multiple systems.
  • Working knowledge of MS office products - Outlook, MS Word and MS-Excel.
• Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).
• Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
• Time management with the ability to cope in a complex, changing environment
• Ability to communicate (oral/written) effectively in a professional office setting

Preferred Skills & Experiences:

• Amisys &/or Xcelys Preferred

NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

For our EEO Policy Statement, please click here. If you'd like more information on your EEO rights under the law, please click here. For Pay Transparency information, please click here.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is 18.00. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.