Sign upLog in

Medical Claims Processor, Xcelys, Remote

NTT DATA

Cary, NC(remote)

Apply
JOB DETAILS
SALARY
SKILLS
Acceptance Testing, Adjudication, Analysis Skills, Automation, Business Operations, Business Services, Claims Processing, Cloud Computing, Communication Skills, Consulting, Corrective Action, Cross-Functional, Current Procedural Terminology (CPT), Documentation, Genetics, Healthcare Common Procedure Coding System (HCPCS), ICD-10, Infrastructure as a Service (IaaS), Legal, Managed Care, Mentoring, Metrics, Network Operations Center, Operational Improvement, Outsourcing, Performance Metrics, Pricing, Process Improvement, Provider Contracting, Provider Relations, Regulations, Regulatory Compliance, Root Cause Analysis, Software Development, Sourcing Strategy, Staff Training, System Integration (SI), System Operations, System Test, Technical Leadership, Trend Analysis, Writing Skills
LOCATION
Cary, NC
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 have been key factors in our company’s growth and market presence. 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.
 
For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.

NTT DATA Services currently seeks Xcelys Medical Claims Examiners to join our team remotely for a 6-18 month contract role.
  1. Must have: XCELYS SYSTEM EXPERIENCE
  2. MINIMUM 3 YEARS CLAIMS EXPERIENCE
  3. Open to work Central Time and PST
  4. 3-4 WEEK TRAINING PERIOD
  5. Must be US based
  6. $20.00 hour W2

To serve as a Medical Claims Processor within the Xcelys managed care software platform  environment. Provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations.

Role Responsibilities:
  1. Adjudication & Review
  • Process comprehensive medical claims using Xcelys and associated subsystems
  • Resolve complex pends, coding issues, and contract exceptions
  • Author overpayment/underpayment determinations and coordinate appeals
  1. Quality & Compliance
  • Engage in quality reviews, audits, root cause analyses
  • Monitor accuracy, variance, and rework metrics
  • Ensure alignment with regulatory and internal compliance guidelines
  1. Support
  • Act as escalation point and subject matter expert
  1. Process & System Improvement
  • Participate in system testing, UAT, and workflow enhancements
  • Recommend improvements, document system and process changes
  1. Reporting & Analytics
  • Prepare production, pending, and quality reports
  • Identify trends and recommend corrective actions
  1. Cross-Functional Collaboration
  • Liaise with provider relations, legal, IT, compliance teams
  • Support internal initiatives related to claims systems / operational improvements

Required Skills/Experience  
  • 3-5+ years claims adjudication experience
  • Minimum of 1 year experience in Xcelys 
  • 2+ years in coding (CPT, ICD-10, HCPCS)
  • 2+ years provider contracts, pricing, regulatory guidelines experience
Preferences
  • Excellent analytical and communication skills
  • Experience training staff or acting as a mentor
  • Familiarity with system testing and documentation
  • Ability to manage high-volume workload and meet performance metrics
Education: Verifiable high school diploma or GED

About NTT DATA Services:

NTT DATA Services 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 Services 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.

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is ($20/hourly ). This range reflects the minimum and maximum 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 is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.

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

Resume Resources

Free Resume TemplatesFree Resume Builder