[Hiring] Medical Claims Examiner @NTTデータ

Role Description

NTT DATA is currently seeking Remote Medical Claims Examiners to join our team.

• 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

Qualifications

• 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
• 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 navigate multiple systems
• Working knowledge of MS Office products like – Outlook, MS Word, and MS Excel

Requirements

• Must be able to work Monday to Friday 7 AM to 4 PM Central time

Benefits

• Compensation: $18/hr
• 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
• AD&D insurance
• Employee assistance
• Participation in a 401K program
• Additional voluntary or legally required benefits