Healthcare Claims Adjuster, Remote US

NTT DATA, Inc.; Kansas City (MO); Remote; USD 22,000 - 28,000; Full time

Job summary

NTT DATA seeks a Remote Claims Processing Associate to support our health care client in a long-term temporary role. You will process professional claim forms, review policies and benefits, and ensure HIPAA compliance while working remotely.

Training runs 8-12 weeks on camera; hours are 7:00 am - 3:30 Central (8:00 am - 4:30 pm EST). Strong troubleshooting, time management and MS Office skills are essential.

Qualifications

• 1-3 years hands-on experience in Healthcare Claims Processing, Claims Adjustments.
• 2+ years using a computer with Windows applications across multiple screens and systems.
• High school diploma or GED.
• Experience in P&Q environment; remote work experience preferred.
• Strong keyboard skills and computer familiarity including multiple screens and MS Office tools.

Responsibilities

• Process Professional claim forms by provider.
• Review policies and benefits.
• Ensure HIPAA, confidentiality, and PHI compliance.
• Adhere to client workflows and SLAs.
• Maintain high quality scores (e.g., above 98.5% PA and 99.75% FA).
• Respond to claims via email with timely resolutions.
• Calculate payable amounts using applicable methodologies/fee schedules.

Skills

Healthcare claims processing

Remote work

Communication

Education

High school diploma or GED

Tools

MS Office

Amisys or Xcelys

Job description

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

Remote Claims Processing Associate

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. This is a Long Term Temporary position supporting a leading manage health care company.

Pleasenote: 8-12 week mandatory training on camera and ramp period between 7:00 am - 3:30 Central Time hours ( 8 - 4:30 EST)

RESUMES should be Complete and Accurate with Education and Employer Names and Dates (month/Year). Prescreen recruitment interviews done F2F using Microsoft Teams.

• Processing of Professional 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

Requirements:

• 1-3 year(s) hands-on experience in Healthcare Claims Processing, Claims Adjustments.
• 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
• High school diploma or GED.
• Previously performing – in P&Q work environment; work from queue; remotely
• Key board skills and computer familiarity –
  • Toggling back and forth between screens/can you navigate multiple systems.
  • Working knowledge of MS office products – Outlook, MS Word and MS-Excel.
• Must be able to work 8 am - 4 pm EST online/remote (training is required on-camera).
• Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
• Time management with the ability to cope in a complex, changing environment
• Ability to communicate (oral/written) effectively in a professional office setting

Preferred Skills & Experiences:

• Amisys or Xcelys preferred.

About NTT DATA

NTT DATA is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.

NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

NTT DATA provides a reasonable range of compensation for specific roles. The hourly rate for this remote role is 18.00 hr. W2 This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance. #INDHRS #LI-NorthAmerica