Medical Claims Processor, Remote

NTT DATA, Inc.; Plano (TX); Remote; USD 35,000 - 50,000; Full time

Job summary

A global technology services company is seeking a Medical Claims Processor to join their remote team in Plano, Texas. The role requires processing claim forms, ensuring compliance with company regulations, and managing claims to meet productivity targets. Ideal candidates will have hands-on experience in healthcare claims processing and be skilled in using various computer applications, including MS Office. This position provides an opportunity to work independently while adhering to set timelines and quality standards.

Qualifications

• 1-3 years of experience in Healthcare Claims Processing required.
• 2+ years of computer usage experience essential.
• Must work online/remote with specific hours.

Responsibilities

• Process professional claim forms by providers.
• Ensure compliance with HIPAA and confidentiality regulations.
• Review and act on claims independently.

Skills

Healthcare Claims Processing

Windows applications

Computer navigation

MS Office (Outlook, Word, Excel)

Education

High school diploma or GED

Job description

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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 Medical Claims Processor, Remote to join our team in Plano, Texas (US-TX), United States (US).

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

Job Requirements and Skills:

• 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 7am - 4 pm CST online/remote (training is required on-camera).

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

Whenever possible, we hire locally to NTT DATA offices or client sites. This ensures we can provide timely and effective support tailored to each client’s needs. While many positions offer remote or hybrid work options, these arrangements are subject to change based on client requirements. For employees near an NTT DATA office or client site, in-office attendance may be required for meetings or events, depending on business needs. At NTT DATA, we are committed to staying flexible and meeting the evolving needs of both our clients and employees. NTT DATA recruiters will never ask for payment or banking information and will only use @nttdata.com and @talent.nttdataservices.com email addresses. If you are requested to provide payment or disclose banking information, please submit a contact us form, https://us.nttdata.com/en/contact-us .

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 .