Medical Claims Processor - Remote

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NTT DATA is currently seeking 20 Remote 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.

Responsibilities

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

Sustain and meet 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

Qualifications

2 years of healthcare claims processing (full cycle: Pay, Pend, Deny)

2 years using a computer with Windows applications that require keyboard use, navigating multiple screens and learning new software tools

High school diploma or GED

Preferred

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; ability to navigate multiple systems

Working knowledge of MS Office products like Outlook, MS Word and MS Excel

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 regard 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 hourly rate for this remote role is $18 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.

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Job metadata

Seniority level: Not Applicable

Employment type: Other

Job function: Health Care Provider

Industries: IT Services and IT Consulting

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