HC and Insurance Operations Analyst

NTT DATA, Inc.; Lincoln (NE); Remote; USD 45,000 - 60,000; Full time

Job summary

A leading company, NTT DATA, is seeking a Claims Case Manager in Lincoln, Nebraska. This role involves managing the claims process from start to finish while ensuring communication with policyholders. The candidate must have strong analytical skills and experience in claims adjudication. Excellent benefits and a flexible work environment will be provided.

Benefits

Medical, dental, and vision insurance

Flexible spending or health savings account

401k program with company match

Paid time off

Short and long-term disability coverage

Qualifications

• 2 years in an analytical role reviewing medical benefits and claims.
• 4 years of experience reviewing and assessing medical records.
• At least 1 year of experience working from home with proven productivity.

Responsibilities

• Handle every aspect of the claim process from intake to final decision.
• Provide frequent updates to claimants through preferred communication channels.
• Thoroughly review medical documents and claim forms.

Skills

Analytical Skills

Communication

Attention to Detail

Empathy

Education

High School Diploma or GED

College Degree (Preferred)

Job description

Press Tab to Move to Skip to Content Link

Select how often (in days) to receive an alert: Create Alert

NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.

We are currently seeking a HC and Insurance Operations Analyst to join our team.

Posisition: Claims Case Manager

This position is eligible for company benefits including medical, dental, and vision insurance with an employer contribution, 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.

Role Overview:We are seeking a dedicated Claims Case Manager to provide comprehensive claim servicing to our insurance policyholders. This role involves managing the entire claims process from intake to final decision, ensuring frequent status updates to claimants through their preferred communication channels (email, phone, mail, etc.). The ideal candidate will have a strong analytical skill set, a thorough understanding of the claims process, and the ability to communicate with empathy and detail.

Pay for this Role $22hr

Key Responsibilities:

• End-to-End Claim Management:Handle every aspect of the claim process, from intake to final decision.
• Status Updates:Provide frequent updates to claimants through their preferred communication channels.
• Document Review:Thoroughly review medical documents, claim forms, and policy notes.
• Communication:Interact with claimants with empathy and attention to detail.
• Team Collaboration:Work with team members to ensure high-quality service and resolution of issues.
• Record Keeping:Maintain accurate records and reports throughout the claims process.
• Data Analysis:Compile and analyze data to identify trends and perform root cause analysis.

Basic Qualifications:

• Experience:
  • 2 years in an analytical role reviewing medical benefits and claims.
  • 2 years of claims adjudication experience, preferably in life, and supplemental products (e.g., critical illnesses such as cancer, stroke, heart attack, kidney disease).
  • 4 years of experience reviewing and assessing medical records.
  • Experience articulating claim requirements clearly and concisely.
• Education:Minimum high school diploma or GED; college degree preferred.
• At least 1 year of experience working from home with proven productivity and quality.
• Designated quiet area for completing calls.

Responsibilities:

• Claim Initiation:Gather information and initiate claims through various channels.
• Detailed Logging:Log and update pertinent information throughout the claim lifecycle.
• Omni-Channel Correspondence:Communicate required medical records and claim information via email, mail, and phone.
• Proactive Follow-Up:Follow up on pending claims and assist in gathering required medical records.
• Benefit Calculation:Calculate benefit amounts and process payments through the claims system.
• Fraud Detection:Identify and flag potential fraudulent activities.
• Multitasking:Manage a caseload of active claims and perform end-to-end steps.
• Attention to Detail:Ensure accuracy and organization in logging, tracking, and reviewing claims.
• Collaboration:Work with management and team members to address service issues and concerns.
• Empathy:Communicate with claimants with empathy and a willingness to help.

If you are passionate about delivering exceptional customer service and have the required qualifications, we encourage you to apply for this rewarding opportunity.

Any state specific certification related to performing the job duties shall be sponsored by the company and successful completion of the certification program is desired.

Required schedule availability for this position is between Monday-Friday 7:00 am to 7:00 pm (Central Time), OT during evenings and Saturdays could also be required based on business need, particularly during the months of Nov – Feb.

New hire must have a working device (such as cell phone or tablet) for the 2-Factor Authentication process

Must Pass Drug screen

Must Pass a background check with Education check and employment verification check.

Remote Working and Technology Requirements

To work remote, individuals must meet all the established Remote requirements including those pertaining to a home workspace and related technology.

Technology

• NTT DATA will provide a computerand headset for remote work.
• Employees are responsible for the care and security of all equipment provided. They must return it immediately upon separation from the company following company protocols.
• Failure to return equipment may result in collection actions and/or other consequences.
• Individuals must provide their own high speed internet access with speeds at or above 50 Mbps.
• A hard-wired ethernet connection is required. Wi-Fi, mobile, wireless and public internet connections are forbidden as are connections outside of one’s personal dwelling or location.

Technical Performance and Issue Tracking

• Management monitors all technical issues and agent downtime. Consistent availability is critical to business operations.
• Remote employees must adhere to all technical support procedures and protocols.
• Chronic connectivity issues or recurring downtimethat impede job performance, including internet outages, may result in the remote status changing to onsite.

Remote Workspace

Remote work demands a high degree of professionalism, self-discipline, and accountability. The following workspace standards are vital to delivering exceptional service.

• Employees must have adedicated, professional workspaceconducive to servicing Customer Service customers with the same quality as an onsite environment.
• The workspace must be apermanent, unencumbered locationused daily for work.
• Employees must work withminimal distractionsthat do not interfere with business operations or service delivery.
• Ideally, the workspace isisolated from other household membersand used exclusively for job duties.
• Background noise, interruptions from people or pets, and other distractionsmust be kept to an absolute minimum to avoid disruptions to customer service.
• Employees must work from thesame location consistentlyunless prior approval is obtained.
• If a change in work location is necessary:
• The new location must meet allRemote Workspace and Technology Requirements.
• Notification to NTT DATA Managementis required before relocating

#INDBPO

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. Visit us atus.nttdata.com

NTT DATA endeavors to make https://us.nttdata.com accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at https://us.nttdata.com/en/contact-us . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here . If you'd like more information on your EEO rights under the law, please click here . For Pay Transparency information, please click here .

Nearest Major Market: Lincoln
Job Segment: Technical Support, Consulting, Telecommunications, Telecom, Network, Technology