Healthcare Claims Processor, Remote

NTT DATA, Inc.; Plano (TX); Remote; USD 45,000 - 65,000; Full time

Job summary

NTT DATA is seeking a Remote Claims Processing Associate to support our end client. You will process professional claim forms, review policies and benefits, and ensure HIPAA confidentiality and PHI standards are met.

Ideal candidates have 1–3 years of healthcare claims processing, strong MS Excel/Word skills, and can work remotely 8 am–4 pm EST with training on-camera. The role requires independent work, good communication and time-management abilities.

Qualifications

• 1-3 year(s) hands-on experience in Healthcare Claims Processing.
• 2+ years using Windows applications and multiple systems; learn new software tools.
• High school diploma or GED.
• Remote work experience in P&Q environment; queue work.
• Keyboard skills and navigating multiple screens; MS Office familiarity.
• Proficient in MS Outlook, Word and Excel.

Responsibilities

• Process professional claim forms by provider.
• Review policies and benefits.
• Comply with HIPAA, confidentiality and PHI.
• Complete client training within timelines.
• Research, review and act on claims independently.
• Prioritize work and adjudicate per SLAs.
• Adjudicate claims per client workflows and guidelines.
• Meet productivity and quality targets to avoid penalties.
• Maintain quality scores above 98.5% PA and 99.75% FA.
• Respond to emails promptly and resolve claims.
• Calculate payable amounts using applicable methodology/fee schedule.

Skills

Healthcare claims processing

MS Excel

MS Word

Outlook

Time management

Communication

Remote work

Education

High school diploma or GED

Tools

Amisys

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.
NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.

In this Role the candidate will be responsible for:

• 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
• 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 Preferred

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 at us.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