Role overview

Qualifications

2+ years of experience in medical claims, provider credentialing, or medical billing/coding
2+ years of experience in a role requiring analysis, critical thinking, independent research
3+ years of computer experience, including Microsoft Office (Outlook, Excel, Word)

Responsibilities

Analyze and process provider-related transactions in accordance with plan guidelines
Research and resolve pended claims by identifying missing or incorrect information
Apply critical thinking and problem-solving to ensure accurate claims processing
Maintain compliance with PHI and HIPAA standards

Key facts

Remote from: Texas (USA)
Full time
Senior (5-10 years)
English

Hard skills

Medical Insurance Claims Medical Billing Quantitative Analysis Provider Data Management

Other skills

Problem Solving
Critical Thinking
Microsoft Office
Detail Oriented
Research

About the company

NTT DATA

Information Technology & Services

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.

Company details

Company typeXLarge

IndustryInformation Technology & Services

Company size10001

Links

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Job description

NTT DATA, Inc. is currently seeking a Remote – Provider Research & Resolution Specialist with 2+ years of experience in medical claims, provider credentialing, or medical billing/coding. This role supports a leading U.S. health plan.

Location: Fully Remote
Pay Rate: $16.75/hour

Key Responsibilities

Analyze and process provider-related transactions in accordance with plan guidelines
Research and resolve pended claims by identifying missing or incorrect information
Apply critical thinking and problem-solving to ensure accurate claims processing
Maintain compliance with PHI and HIPAA standards
Follow established policies and procedures while identifying improvement opportunities
Handle non-routine, research-based tasks requiring independent judgment

Required Qualifications

2+ years of experience in medical claims, provider credentialing, or medical billing/coding
2+ years of experience in a role requiring analysis, critical thinking, independent research, with the ability to investigate issues and resolve discrepancies in complex information (Strong attention to detail and accuracy)
3+ years of computer experience, including Microsoft Office (Outlook, Excel, Word)

Preferred Experience

Experience with provider data management or credentialing
Facets experience is a plus
Typing speed of 40+ WPM

Education

High School Diploma or equivalent

NTT DATA provides a reasonable range of compensation for specific roles. The hourly rate for this remote role is $16.75/hourly. This rate reflects the 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.

This position may also be eligible for incentive compensation based on individual and/or company performance.

This position is eligible for company benefits including participation in medical, dental, and vision insurance, flexible spending or health savings account, and AD&D insurance, employee assistance, participation in a 401K program, and additional voluntary or legally required benefits.

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 accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

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