Claims Processing Associate - Remote

Req ID: 336565 

NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.

We are currently seeking a Claims Processing Associate - Remote to join our team in Plano, Texas (US-TX), United States (US).

• In this Role the candidate will be responsible for:

  • 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

   
  Requirements:

  • 3 year(s) hands-on experience in Healthcare Claims Processing
  • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
  • High school diploma or GED.
  • Previously performing – in P&Q work environment; work from queue; remotely
  • Key board skills and computer familiarity –
  • Toggling back and forth between screens/can you navigate multiple systems.
  • Working knowledge of MS office products – Outlook, MS Word and MS-Excel.  
  • Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).

   
  Preferred Skills & Experiences:

  • Amisys
  • Ability to communicate (oral/written) effectively in a professional office setting
  • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
  • Time management with the ability to cope in a complex, changing environment

- Creating smart & impactful PowerPoint presentations  

Preferences: 

 - Develop/improve statistical and predictive modeling algorithms and visualization to fit the use cases.

- Experience in Advanced Excel Application and Automation reports (VBA/Visual Studio) - Effective troubleshooting skills where you can leverage your research, analysis, and problem solving skills.

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. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure and connectivity. We are one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. Visit us at us.nttdata.com

Whenever possible, we hire locally to NTT DATA offices or client sites. This ensures we can provide timely and effective support tailored to each client’s needs. While many positions offer remote or hybrid work options, these arrangements are subject to change based on client requirements. For employees near an NTT DATA office or client site, in-office attendance may be required for meetings or events, depending on business needs. At NTT DATA, we are committed to staying flexible and meeting the evolving needs of both our clients and employees. NTT DATA recrui