Medical Claims Processor - Remote

Medical Claims Processor - Remote

Join to apply for the Medical Claims Processor - Remote role at NTT DATA North America.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company’s growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

For more than 25 years, NTT DATA has focused on impacting the core of your business operations with industry‑leading outsourcing services and automation. With our industry‑specific platforms, we deliver continuous value addition and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one‑time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.

Note
:
This is a US based, W-2 project. All candidates will be paid through NTT DATA only.

• Processing of Professional claim forms files by provider
• Reviewing the policies and benefits
• Comply with company regulations regarding HIPAA, confidentiality, and PHI
• Abide with the timelines to complete compliance training of NTT Data/Client
• Work independently to research, review and act on the claims
• Prioritize work and adjudicate claims as per turnaround time/SLAs
• Ensure claims are adjudicated as per clients defined workflows, guidelines
• Sustaining and meeting the client productivity/quality targets to avoid penalties
• Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
• Timely response and resolution of claims received via emails as priority work
• Correctly calculate claims payable amount using applicable methodology/ fee schedule

• 1-3 years hands‑on experience in Healthcare Claims Processing
• 2+ years using a computer with Windows applications, navigating multiple screens and computer systems, and learning new software tools
• High school diploma or GED.

• Amisys &/or Xcelys Preferred
• Time management with the ability to cope in a complex, changing environment
• Effective troubleshooting where you can leverage your research, analysis and problem‑solving abilities
• Previously performing - in P&Q work environment; work from queue; remotely

Must be able to work 7am - 4pm CST online/remote (training is required on‑camera).

About NTT DATA: NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long‑term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. NTT DATA is part of NTT Group and headquartered in Tokyo.

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NTT DATA is an equal opportunity employer and considers all applicants without regard 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.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is ($18.00 - $18.00/hourly ). This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short‑and long‑term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.

Seniority level:
Not applicable.

Employment type:

Other.

Job function:
Health Care Provider.

Industries: IT Services and IT Consulting.