Healthcare Claims Examiner, Remote

NTT DATA

Tampa, FL(remote)

JOB DETAILS
SKILLS
Adjudication, Analysis Skills, Business Services, Claims Processing, Cloud Computing, Communication Skills, Computer Systems, Consulting, Establish Priorities, Genetics, HIPAA (Health Insurance Portability and Accountability Act), Healthcare, Healthcare Management, High School Diploma, Identify Issues, Infrastructure as a Service (IaaS), Keyboards, Microsoft Excel, Microsoft Office, Microsoft Outlook, Microsoft Windows Operating System, Microsoft Word, Network Operations Center, Presentation/Verbal Skills, Problem Solving Skills, Quality Management, Regulations, Service Level Agreement (SLA), Software Development, System Integration (SI), Technical Leadership, Time Management, Typing
LOCATION
Tampa, FL(remote)
POSTED
30+ days ago
At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. This is a Long Term Temporary position supporting a leading manage health care company.
Please note: 8-12 week mandatory training on camera and ramp period between 7 - 4:30 CT.
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:
  • 1-3 year(s) hands-on experience in Healthcare Claims Processing, Claims Adjustments.
  • 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.
  • Must be able to work 8 am - 4 pm EST online/remote (training is required on-camera).
  • 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
  • Ability to communicate (oral/written) effectively in a professional office setting

Preferred Skills & Experiences:
  • Amisys or Xcelys preferred.


About NTT DATA

About NTT Data :

NTT DATA is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success. Visit nttdata.com or LinkedIn to learn more.

 

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.

 

NTT DATA provides a reasonable range of compensation for specific roles. The  hourly range for this remote role is 18.00 hr. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of 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.

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