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

Abiding with the timelines to complete compliance training of NTT Data/Client

Working independently to research, review and act on the claims

Prioritizing work and adjudicating claims as per turnaround time/SLAs

Ensuring 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 calculating claims payable amount using applicable methodology/fee schedule

Requirements:

1-3 year(s) hands-on experience in Healthcare Claims Processing

2+ year(s) 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 8:00 4:30 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:

Amisys 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.