Medical Claims Processor (Home-Based)

Job Title : Medial Claims Processor

Healthcare

Operations

Location : Work at Home

Processing of Professional and Hospital claim forms files by provider
Reviewing the policies and benefits

• 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+ year(s) of Medical Claims experience
• 2+ year(s) using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools
• 1+ years of working with Claims Adjudication Systems
• High School diploma or equivalent

Ability to communicate (oral/written) effectively in a professional office setting

• Effective troubleshooting skills where you can leverage your research, analysis and problem-solving skills
• Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is $17.00-18.00. This range reflects the minimum and maximum target compensation for the position across all US locations. This position may also be eligible for incentive compensation based on individual and/or company performance.

Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.

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