• Job Description

  Req#: 357714

  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:
  • 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 –
  o Toggling back and forth between screens/can you navigate multiple systems.
  o Working knowledge of MS office products – Outlook, MS Word and MS-Excel.

  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

• About the company

  Japan Telegraph and Telephone Public Corporation, a predecessor of NTT, started Data Communications business in 1967.

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