Remote Medical Claims Examiner — Evening IST

NTT America, Inc.; Plano (TX); A distancia; USD 36.000 - 48.000; Jornada completa

Descripción de la vacante

NTT DATA seeks a Medical Claims Examiner to join our team in Plano, Texas. This role focuses on reviewing and processing insurance claims, validating information, and determining payment criteria in alignment with policy and procedures.

As a Remote position, you will coordinate benefits, maintain productivity, and resolve complex situations while building expertise in healthcare insurance processes. Strong data entry, attention to detail, and English proficiency are essential.

Formación

• University degree or equivalent required; formal studies of English language and basic math.
• 6+ months of experience applying business rules to varying fact situations.
• 6+ months of data entry with focus on quality, accuracy and accountability.

Responsabilidades

• Review and process insurance claims.
• Validate Member, Provider and other Claim information.
• Determine accurate payment criteria for clearing pending claims based on policy and procedure.
• Coordinate of Claim Benefits based on Policy & Procedure.
• Maintain productivity goals, quality standards and aging timeframes.
• Scrutinizing Medical Claim Documents and settlements.
• Organize and complete tasks per assigned priorities.
• Develop and maintain knowledge of healthcare insurance industry and products/services.
• Resolve complex situations following established guidelines.

Conocimientos

Data entry

Attention to detail

Time management

Communication skills

English proficiency

Educación

University degree or equivalent

Herramientas

Windows PC

Descripción del empleo

NTT DATA seeks a Medical Claims Examiner to join our team in Plano, Texas. This role focuses on reviewing and processing insurance claims, validating information, and determining payment criteria in alignment with policy and procedures.

As a Remote position, you will coordinate benefits, maintain productivity, and resolve complex situations while building expertise in healthcare insurance processes. Strong data entry, attention to detail, and English proficiency are essential.