Medical Claims Examiner - Remote U.S.

NTT DATA

Dallas, TX(remote)

JOB DETAILS
SALARY
SKILLS
Accidental Death and Dismemberment (AD&D), Adjudication, Artificial Intelligence (AI), Business Services, Claims Processing, Communication Skills, Computer Systems, Consulting, Ecosystems, Establish Priorities, Genetics, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Hospital, Insurance, International Business, Keyboards, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft Windows Operating System, Microsoft Word, Presentation/Verbal Skills, Quality Management, Regulations, Research & Development (R&D), Service Level Agreement (SLA), Startup, Time Management
LOCATION
Dallas, TX(remote)
POSTED
4 days ago
NTT DATA is currently seeking Remote Medical Claims Examiners to join our team.
(Amisys or Xcelys experience is a plus) 
***Must be able to work Monday to Friday 7 AM to 4 PM Central time.
 
In this Role the candidate will be responsible for:
  • Processing of Professional and Hospital 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/
Required Skills for this role include:
  • 2+ years of healthcare claims processing (full cycle: Pay, Pend, Deny)
  • 2+ years using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools
  • High school diploma or GED.
Preference
  • Experience processing claims in Amisys or Xcelys is a plus.
  • Ability to communicate (oral/written) effectively in a professional office setting
  • 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.

NTT DATA provides a reasonable range of compensation for specific roles. The rate for this remote role is $18/hour. This rate reflects the 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 may also be eligible for incentive compensation based on individual and/or company performance.  
 
This position is eligible for company benefits including participation in medical, dental, and vision insurance, flexible spending or health savings account, and AD&D insurance, employee assistance, participation in a 401K program, and additional voluntary or legally required benefits.

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.
 


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About the Company

N

NTT DATA

NTT DATA means Business

NTT DATA is your Innovation Partner anywhere around the world. With business operations in more than 50 countries, we put emphasis on long-term commitment and combine global reach and local intimacy to provide premier professional services from consulting, system development, business process and IT outsourcing, to cloud-based solutions.

NTT DATA Americas' Strategic Staffing group provides our clients with top notch technical talent to augment their core IT staff. Our approach is customer centric, partnering to assist you in achieving your strategic goals and IT initiatives. We get to know your company’s culture and the type of technical staff that thrive within your organization. We understand your specific technical and business requirements, timing, and budget.

  • NTT DATA is part of the NTT Group – a Fortune 31 Global IT & Telecom services company.
  • NTT Group one of the largest Telecommunications Companies in the world.
  • NTT DATA is ranked in the top 10 largest global IT services provider in the world.
Collectively, the integrated company generates $16B in annual revenues with over 130,000 employees across 50 countries Visit www.nttdata.com/americas to learn how our consultants, projects, managed services, and outsourcing engagements deliver value for a range of businesses and government agencies.

COMPANY SIZE
10,000 employees or more
INDUSTRY
Management Consulting Services
EMPLOYEE BENEFITS
Retirement / Pension Plans
FOUNDED
1967
WEBSITE
http://americas.nttdata.com/Careers/Careers.aspx