Remote Medical Claims Adjudicator

NTT Data Americas, Inc.; Missouri; Hybride; USD 23 000 - 25 000; Plein temps

Résumé du poste

NTT DATA Americas, Inc. is seeking a Medical Claims Processor to handle professional and hospital claim forms, review benefits, and adjudicate claims in a work-at-home setting.

This entry-to-mid level role requires at least 2 years of medical claims experience, familiarity with claims adjudication systems, and a high school diploma. The position emphasizes HIPAA compliance, timely responses, and meeting SLAs, with a pay rate of $17.00–$18.00 per hour and eligibility for company benefits.

Qualifications

• 2+ years of Medical Claims experience.
• 2+ years using Windows-based computer systems and navigating multiple screens.
• 1+ years of working with Claims Adjudication Systems.
• High School diploma or equivalent.

Responsabilités

• Processing of Professional and Hospital claim forms files by provider.
• Reviewing the policies and benefits.
• Comply with HIPAA, confidentiality, and PHI.
• Abide with timelines to complete compliance training.
• Work independently to research, review and adjudicate the claims.
• Prioritize work and adjudicate claims as per turnaround time/SLAs.
• Ensure claims adjudication per client workflows and guidelines.
• Maintain quality scores above targets and productivity.
• Timely response and resolution of claims received via emails.
• Calculate claims payable amount using applicable methodology/ fee schedule.

Description du poste

NTT DATA Americas, Inc. is seeking a Medical Claims Processor to handle professional and hospital claim forms, review benefits, and adjudicate claims in a work-at-home setting.

This entry-to-mid level role requires at least 2 years of medical claims experience, familiarity with claims adjudication systems, and a high school diploma. The position emphasizes HIPAA compliance, timely responses, and meeting SLAs, with a pay rate of $17.00–$18.00 per hour and eligibility for company benefits.