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Medical Claims Processor, Remote
Medical Claims Processor, RemoteNTT • Plano, United States
Medical Claims Processor, Remote

Medical Claims Processor, Remote

NTT • Plano, United States
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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
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