Job Details

Remote Claims Processing Associate

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
• Complying 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 years hands-on experience in Healthcare Claims Processing
• 2+ years 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 8 am - 4 pm EST 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:

Xcelys 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.