What are the responsibilities and job description for the HC & Insurance Operations Processing Sr Rep position at NTT DATA Services?
Req ID : 313273
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 HC & Insurance Operations Processing Sr Rep to join our team in Plano, Texas (US-TX), United States (US).
NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.
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 :
Toggling back and forth between screens / can you navigate multiple systems.
Preferred Skills & Experiences :
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
NTT DATA endeavors to make https : / / us.nttdata.com accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at https : / / us.nttdata.com / en / contact-us . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here . If you'd like more information on your EEO rights under the law, please click here . For Pay Transparency information, please click here .
Salary : $4
