Role Description
NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.
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Processing of Professional claim forms files by provider
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Reviewing the policies and benefits
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Comply with company regulations regarding HIPAA, confidentiality, and PHI
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Abide with the timelines to complete compliance training of NTT Data/Client
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Work independently to research, review and act on the claims
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Prioritize work and adjudicate claims as per turnaround time/SLAs
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Ensure claims are adjudicated as per clients defined workflows, guidelines
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Sustaining and meeting the client productivity/quality targets to avoid penalties
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Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA
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Timely response and resolution of claims received via emails as priority work
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Correctly calculate claims payable amount using applicable methodology/fee schedule
Qualifications
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1-3 year(s) hands-on experience in Healthcare Claims Processing
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2+ year(s) using a computer with Windows applications
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High school diploma or GED
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Previously performing in P&Q work environment; work from queue; remotely
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Key board skills and computer familiarity
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Working knowledge of MS office products β Outlook, MS Word and MS-Excel
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Must be able to work 8 am - 4 pm EST online/remote (training is required on-camera)
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Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
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Time management with the ability to cope in a complex, changing environment
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Ability to communicate (oral/written) effectively in a professional office setting
Preferred Skills & Experiences
Company Description
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.
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Global Top Employer with diverse experts in more than 50 countries
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Robust partner ecosystem of established and start-up companies
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Services include business and technology consulting, data and artificial intelligence, industry solutions
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Development, implementation and management of applications, infrastructure and connectivity
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Leading provider of digital and AI infrastructure in the world
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Part of NTT Group, investing over $3.6 billion each year in R&D