Representative I, Clinical Services

NTT DATA; Woonsocket (RI); Remote; USD 20,000 - 29,000; Full time

Job summary

NTT DATA Services seeks a Clinical Services Representative I for a 100% remote role. Expect 8am–11pm EST shifts, 40 hours/week, with an initial 4-week training period 8am–4:30pm EST. Start date: November 2, 2026, with a 6–12 month duration.

The role handles inbound calls, documents reviews, and escalates to pharmacists as needed. Requires 1+ year of prior authorization experience and MS Office skills; college degree preferred.

Qualifications

• 1+ year of Medical Prior authorization experience.
• Ability to apply basic computer skills and take a computer assessment.
• 1+ year of Microsoft Office Suite experience: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable.

Responsibilities

• Handle inbound calls from providers, pharmacies, and members with professional assistance.
• Document reviews completely and accurately; transfer complex questions to pharmacists.
• Assist with outbound calls, process Prior Auths via fax and ePA, monitor inquiries.

Skills

Medical Prior authorization

Computer skills

Microsoft Office Suite

Education

High School diploma or GED

College Degree Preferred

Tools

Excel

Word

Access

Outlook

PowerPoint

Visio

Job description

NTT DATA Services currently seeks a Clinical Service, Representative I to join our team working 100% Remote.

• Hours: 8am to 11pm EST, 8 hours per day/ 40 hours per week. Training 8am-4:30pm EST for 4 weeks on camera.
• Duration: 6 months to 1 year
• Start: November 2, 2026
• Computer assessment and Internet Speed test is required.

Position Summary

The Representative I, Clinical Services takes in-bound calls from providers, pharmacies, and members etc, providing professional and courteous phone assistance to all callers through the criteria based prior authorization process. Maintains complete, timely and accurate documentation of reviews. Transfers all clinical questions, escalations and judgement calls to the pharmacist team.

The Rep I, Clinical Services will also assist with other duties as needed to include but not limited to: outbound calls, reviewing and processing Prior Auth's received via fax and ePA, monitoring and responding to inquiries via department mailboxes and other duties as assigned by the leadership team.

Required Job Qualifications

• 1+ year of Medical Prior authorization experience
• Ability to apply basic computer skills and take a computer assessment
• 1+ year of Microsoft Office Suite experience: Excel and Word required; Access, Outlook, PowerPoint, Visio preferable.

Preferred Qualifications

• Must be able to multitask and utilize multiple system applications simultaneously.
• Basic pharmaceutical knowledge pertaining to terminology, calculations, and protocols.
• Must be able to utilize available resources independently and provide high quality work.
• Must be able to absorb presented information, display motivation, seek development and problem solve.
• Ability to adapt and change with workflow and shifting priorities.
• Must possess excellent written, verbal, grammar, and listening communication skills.
• Must be able to deal with a diverse customer base (internal and external) in a friendly and confident manner.
• Ability to maintain confidentiality of PHI (Protected Healthcare Information).

Education

• High School diploma or GED Required.
• College Degree Preferred

About NTT Data

NTT DATA is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.

NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.

NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is 18.25.This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance.