Key Facts

Remote From:

Texas (USA)

Full time

Senior (5-10 years)

6 - 69K yearly

English

Hard Skills

Medical Insurance Claims Adjudication Data Entry Claims And Litigation Management Benefits Administration Online Communication Problem Management

Other Skills

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Microsoft Excel
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Quality Assurance
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Microsoft Word
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Microsoft Outlook
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Non-Verbal Communication
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Adaptability
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Time Management
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Prioritization

Roles & Responsibilities

1-3 year(s) hands-on experience in Healthcare Claims Processing
2+ year(s) using a computer with Windows applications and learning new software tools
High school diploma or GED
Must be able to work 7am - 4pm CST remotely

Requirements:

Processing of professional claim forms and reviewing provider policies and benefits
Adjudicate claims and prioritize work according to turnaround times and SLAs
Ensure compliance with HIPAA, confidentiality, and PHI; adhere to client workflows and guidelines
Provide timely responses and resolutions to claims received via emails; maintain accurate calculation of claims payable

Job description

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 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).
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 Preferred

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. 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 one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. Visit us at us.nttdata.com

NTT DATA endeavors to make https://us.nttdata.com accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at https://us.nttdata.com/en/contact-us . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. 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 .