NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. Our consulting and industry solutions help organizations and society move confidently and sustainably into the digital future. Global Top Employer with experts in more than 50 countries Access to a robust ecosystem of innovation centers and established/start-up partners Part of NTT Group, investing over $3 billion each year in R&D
Medical Claims Processor
Location
United States
Posted
7 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
We are currently seeking a Medical Claims Processor 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
- Complying with company regulations regarding HIPAA, confidentiality, and PHI
- Abiding by the timelines to complete compliance training of NTT Data/Client
- Working independently to research, review and act on the claims
- Prioritizing work and adjudicating claims as per turnaround time/SLAs
- Ensuring 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 calculating claims payable amount using applicable methodology/fee schedule
Qualifications
- 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
Requirements
- 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
Company Description
NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services.
As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D.
Job 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
- 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
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