Key Facts

Remote From:

Texas (USA)

Category: Insurance Claims Examiner

Full time

Senior (5-10 years)

English

Hard Skills

Xcelsius Windows Software

Other Skills

•
Microsoft Office
•
Communication
•
Problem Solving
•
Time Management
•
Detail Oriented

Roles & Responsibilities

2+ years of healthcare claims processing (full cycle: Pay, Pend, Deny)
2+ years using a computer with Windows applications
High school diploma or GED
Experience processing claims in Amisys or Xcelys is a plus

Requirements:

Processing of Professional and Hospital claim forms files by provider
Reviewing the policies and benefits
Comply with company regulations regarding HIPAA, confidentiality, and PHI
Work independently to research, review and act on the claims

Job description

NTT DATA is currently seeking Remote Medical Claims Examiners to join our team.

(Amisys or Xcelys experience is a plus)

***Must be able to work Monday to Friday 7 AM to 4 PM Central time.

In this Role the candidate will be responsible for:

Processing of Professional and Hospital 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/

Required Skills for this role include:

2+ years of healthcare claims processing (full cycle: Pay, Pend, Deny)
2+ years using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools
High school diploma or GED.

Preference

Experience processing claims in Amisys or Xcelys is a plus.
Ability to communicate (oral/written) effectively in a professional office setting
Familiar with toggling back and forth between screens/can you navigate multiple systems.
Working knowledge of MS office products like – Outlook, MS word and MS-excel.

NTT DATA provides a reasonable range of compensation for specific roles. The rate for this remote role is $18/hour. 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 an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

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