Medical Claims Examiner - Remote U.S.

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. 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 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 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. Preferences 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. Compensation & Benefits 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. Equal Employment Opportunity Statement 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. #J-18808-Ljbffr