Senior Healthcare Claims & Care Specialist

NTT DATA, Inc.; Quezon; On-site; PHP 223,000 - 357,000; Full time

Job summary

NTT DATA, Inc. is seeking an entry to mid-level associate in the Philippines to review electronic records and insurance submissions for completeness, and to assist with inquiries via phone and written correspondence.

The role involves learning CRM tools and performing inbound/outbound calls to US-based providers and customers to support service standards. You will analyze medical insurance claims for quality assurance and resolve routine questions using established guidelines, while maintaining

Qualifications

• Proficiency in Microsoft Office and general computer operations.
• Must master the English language, both oral and written.
• Detail-oriented and organized to maintain accurate records.
• Ability to focus and work quickly; able to work independently.
• Sense of urgency in reporting concerns to immediate supervisor.
• 1-2 years' experience in the medical field preferred.
• High School diploma or equivalent required.

Responsibilities

• Performs timely and accurate review of electronic records/documentation scanning for completeness of submissions in accordance with established policies.
• Identifies opportunities and reports on inaccuracies that may be present in reviewed documents
• Learns CRM system and is able to access different internal online resources to obtain required information in a timely manner.
• Performing inbound and outbound calls to insurance companies, medical facilities and customers in the US.
• Responding to customer requests by phone and/or in writing to ensure customer satisfaction and to assure that service standards are met
• Analyzing medical insurance claims for quality assurance
• Resolving moderately routine questions following pre-established guidelines
• Performing routine research on customer inquiries.
• Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team

Skills

Attention to detail

English fluency

Microsoft Office

Education

High School diploma or equivalent

Tools

CRM systems

Job description

NTT DATA, Inc. is seeking an entry to mid-level associate in the Philippines to review electronic records and insurance submissions for completeness, and to assist with inquiries via phone and written correspondence.

The role involves learning CRM tools and performing inbound/outbound calls to US-based providers and customers to support service standards. You will analyze medical insurance claims for quality assurance and resolve routine questions using established guidelines, while maintaining