High school diploma or GED is required., 1-3 years of hands-on experience in healthcare claims processing., Proficiency in computer applications, including MS Office (Outlook, Word, Excel)., Ability to navigate multiple screens and learn new software tools quickly..
Key responsibilities:
Process professional claim forms and review policies and benefits.
Research, review, and act on claims independently to meet deadlines.
Ensure claims are adjudicated according to client workflows and guidelines.
Respond promptly to claims received via email and maintain quality and productivity targets.
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NTT DATA – a part of NTT Group – is a trusted global innovator of IT and business services headquartered in Tokyo. We help clients transform through consulting, industry solutions, business process services, digital & IT modernization and managed services. NTT DATA enables them, as well as society, to move confidently into the digital future. We are committed to our clients’ long-term success and combine global reach with local client attention to serve them in over 50 countries around the globe.
NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.
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).
Preferred Skills & Experiences:
Amisys Preferred
Ability to communicate (oral/written) effectively in a professional office setting
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
About NTT DATA
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com .
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The pay rate for this remote role is $18 Hourly . This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
Required profile
Experience
Level of experience:Entry-level / graduate
Spoken language(s):
English
Check out the description to know which languages are mandatory.