HC and Insurance Operations Analyst

NTT DATA; Lincoln (NE); On-site; USD 60,000 - 80,000; Full time

Job summary

A leading company seeks a Claims Case Manager to manage the claims process, ensuring customer service excellence. Applicants should have a strong analytical background, familiarity with claims adjudication, and the ability to communicate effectively with policyholders. This role offers a competitive hourly wage and comprehensive benefits.

Benefits

Medical, dental, and vision insurance

Flexible spending or health savings account

401k program with company match

Qualifications

• 2 years in an analytical role reviewing medical benefits and claims.
• 2 years of claims adjudication experience, preferably in life and supplemental products.
• 4 years of experience reviewing and assessing medical records.

Responsibilities

• Handle every aspect of the claims process, from intake to final decision.
• Provide updates to claimants through preferred communication channels.
• Interact with claimants with empathy and attention to detail.

Skills

Analytical skills

Communication

Empathy

Attention to detail

Education

High school diploma or GED; college degree preferred

Job description

Req ID: 317833

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.

Position: 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 strong analytical skills, a thorough understanding of the claims process, and the ability to communicate with empathy and detail.

Pay for this Role: $22/hr

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.
• Work Environment:
  • 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: Monday-Friday, 7:00 am to 7:00 pm (Central Time). OT during evenings and Saturdays may be required during Nov – Feb based on business needs.

New hires must have a working device (cell phone or tablet) for 2-factor authentication.

Must pass drug screening and background checks, including education and employment verification.

Remote Working and Technology Requirements

To work remotely, individuals must meet all established remote requirements, including a suitable home workspace and technology.

Technology:

• NTT DATA will provide a computer and headset for remote work.
• Employees are responsible for the care and security of all provided equipment and must return it upon separation.
• Employees must have high-speed internet (≥50 Mbps), with a wired Ethernet connection; Wi-Fi, mobile, wireless, or public internet connections are not permitted.

Technical Performance and Issue Tracking

• Management monitors all technical issues and downtime. Consistent availability is critical.
• Adherence to support procedures is required; chronic connectivity issues may result in a change to onsite status.

Remote Workspace

Employees must maintain a professional, dedicated workspace free from distractions, used consistently for work, and meeting all remote workspace standards. Changes in location require prior notification and must meet all standards.

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About NTT DATA

NTT DATA is a $30 billion global leader in business and technology services, serving 75% of the Fortune Global 100. We are committed to innovation, diversity, and long-term success. Visit us at us.nttdata.com.

We strive to make our website accessible. For assistance or accommodations, contact us at https://us.nttdata.com/en/contact-us. NTT DATA is an equal opportunity employer, and consideration for employment is provided without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status. See our EEO Policy.