Remote Provider Claims Research & Resolution Expert

NTT DATA North America; Dallas (TX); On-site; USD 22,041 - 24,796; Full time

Benefits offered by this job

Participation in medical, dental, and vision insurance

Flexible spending or health savings account

401K program

Employee assistance program

Job summary

NTT DATA North America is seeking a Remote Provider Research & Resolution Specialist with 2+ years of experience in medical claims, provider credentialing, or billing. This role involves analyzing transactions and resolving claims by identifying information discrepancies.

The position requires expertise in compliance with PHI and HIPAA standards and critical thinking to improve claims processing. Various benefits, including medical insurance and a 401K program, are offered.

Qualifications

• 2+ years of experience in medical claims, provider credentialing, or medical billing/coding.
• 2+ years of experience requiring analysis, critical thinking, and independent research.
• 3+ years of computer experience, including Microsoft Office (Outlook, Excel, Word).

Responsibilities

• Analyze and process provider-related transactions according to plan guidelines.
• Research and resolve pended claims by identifying missing or incorrect information.
• Maintain compliance with PHI and HIPAA standards.

Skills

Medical claims processing

Critical thinking

Attention to detail

Research ability

Microsoft Office

Education

High School Diploma or equivalent

Job description

NTT DATA North America is seeking a Remote Provider Research & Resolution Specialist with 2+ years of experience in medical claims, provider credentialing, or billing. This role involves analyzing transactions and resolving claims by identifying information discrepancies.

The position requires expertise in compliance with PHI and HIPAA standards and critical thinking to improve claims processing. Various benefits, including medical insurance and a 401K program, are offered.