What are the responsibilities and job description for the Claims Examiner - REMOTE position at NTT DATA Services?

Req ID : 308188

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 Examiners to join our team working remote, US.

NTT DATA's Client is seeking a Remote Healthcare Claims Processing Associate to join our team!

Must be able to work Monday to Friday 7 AM to 4 PM CST.

In this Role the candidate will be responsible for :

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

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 schedules

Required Skills for this role include :

An education level of at least a high school diploma or GED.

3 year(s) experience processing of Professional and Hospital claim forms files by provider

3 year(s) demonstrated work experience prioritizing work and adjudicating claims as per turnaround times / SLAs

1 year(s) of experience in a role that required a focus on quality including attention to detail, accuracy and accountability of work

2 year(s) using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools

Preferences :

Understanding of previous quality, production and attendance parameters,

Understanding and adhering to working hours and leave policy.

Key board skills and computer familiarity –

typing test required.

familiar with toggling back and forth between screens / can you navigate multiple systems.

Working knowledge of MS office products like – Outlook, MS word and MS-excel.

Ability to communicate (oral / written) effectively in a professional office setting

Effective troubleshooting skills where you can leverage your research, analysis and problem-solving skills

Time management skills that require the ability to cope with a complex, changing environment

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. 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 also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com .

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.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The pay wage for this role is $18 / hour. This reflects the target compensation for the position across all US locations.

Salary : $4

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