Healthcare Claims Processor, Remote

Healthcare Claims Processor, Remote at NTT DATA

At NTT DATA, we understand that having the right people on board makes anything possible. The dedication, integrity, and commitment of our employees are crucial to our company's growth, market presence, and ability to help clients stay ahead. By hiring the best and fostering their professional and personal development, we ensure a bright future for both NTT DATA and our team members.

NTT DATA is currently looking to hire a 1-year Temporary - Remote Claims Processing Associate for one of our end clients. There is potential for this role to transition into a direct hire position.

In This Role, The Candidate Will Be Responsible For:

• Processing professional claim forms filed by providers.
• Reviewing policies and benefits accurately.
• Complying with company regulations regarding HIPAA, confidentiality, and PHI.
• Abiding by timelines for completing compliance training for NTT DATA and the client.
• Working independently to research, review, and act on claims.
• Prioritizing work and adjudicating claims according to turnaround time and SLAs.
• Ensuring claims are adjudicated as per clients' defined workflows and guidelines.
• Sustaining and meeting client productivity and quality targets to avoid penalties.
• Maintaining quality scores above 98.5% PA (Processing Accuracy) and 99.75% FA (Financial Accuracy).
• Timely response and resolution of claims received via emails as priority work.
• Correctly calculating claims payable amounts using applicable methodology and fee schedules.

Requirements

• 1-3 year(s) hands-on experience in Healthcare or Medical Claims Processing.
• 2+ year(s) using a computer with Windows applications, including keyboard proficiency, navigating multiple screens and computer systems, and learning new software tools.
• High school diploma or GED.
• Previously performed in a P&Q (Productivity & Quality) work environment; experience working from a queue remotely.
• Strong keyboard skills and computer familiarity – ability to toggle back and forth between screens and navigate multiple systems.
• Working knowledge of MS Office products – Outlook, MS Word, and MS-Excel.
• Must be able to work 7 am - 4 pm CST online/remote (training is required on-camera).
• Effective troubleshooting skills, leveraging research, analysis, and problem-solving abilities.
• Time management with the ability to cope in a complex, changing environment.
• Ability to communicate effectively (oral/written) in a professional office setting.

Preferred Skills & Experiences

• Amisys Preferred or Xcelys Claims System experience.

About NTT DATA

NTT DATA is a $30 billion global innovator in business and technology services, serving 75% of the Fortune Global 100. We are dedicated to helping clients innovate, optimize, and transform for enduring success. As a Global Top Employer, we have diverse experts in over 50 countries and a robust ecosystem of established and startup partners. Our comprehensive services include business and technology consulting, data and artificial intelligence solutions, industry-specific solutions, as well as the development, implementation, and management of applications, infrastructure, and connectivity. We stand as a leading provider of digital and AI infrastructure worldwide. As part of NTT Group, we invest over $3.6 billion annually in R&D to empower organizations and society to confidently and sustainably advance into the digital future. Learn more at us.nttdata.com.

Key skills/competency

• Claims Processing
• HIPAA Compliance
• Medical Adjudication
• Productivity Targets
• Quality Assurance
• Microsoft Office
• Data Entry
• Time Management
• Troubleshooting
• Healthcare Industry