NTT DATA

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. 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.

HC & Insurance Operations Processing Sr Rep

InsuranceInsuranceFull TimeRemoteTeam 10,001

Location

United States

Posted

4 days ago

Salary

Not specified

No structured requirement data.

Job Description

"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"

Related Categories

Related Job Pages

More Insurance Jobs

Contract and Insurance Specialist

Smart Tech Contracting, LLC

From Design to Deployment: Comprehensive Automation Solutions for Mission Critical Facilities

Insurance4 days ago
Full TimeRemoteTeam 11-50Since 2025

Contract and Insurance Specialist managing legal compliance at Smart Tech Contracting

United States
$99.8K - $120.2K / year
Insurance4 days ago
Full TimeRemote

The Insurance Supervisor is responsible for overseeing and guiding staff that are assigned to client-contracted work, ensuring quality performance and adherence to project goals. This role ensures that staff are being supported and mentored in their professional growth while moni...

United States
$60K - $70K / year

Health & Life Insurance Agent - Remote

The Summers Agency

The Summers Agency is expanding and looking for individuals interested in starting or growing a career in insurance sales.

Insurance4 days ago
Full TimeRemoteTeam 14Since 2015

The primary role involves meeting with clients virtually to assess their insurance needs and assisting them in securing appropriate coverage for health and life insurance products. This is a commission-based sales position with provided warm leads.

United States
$70K - $125K / year

Insurance Agent - Remote

The Summers Agency

The Summers Agency is expanding and looking for individuals interested in starting or growing a career in insurance sales.

Insurance4 days ago
Full TimeRemoteTeam 14Since 2015

The agent will contact warm leads to schedule virtual or phone appointments, build rapport, and present insurance solutions to families, aiming to work with 10 to 15 families weekly. Responsibilities also include learning mortgage protection and retirement protection products with opportunities for leadership growth.

United States
$70K - $125K / year