Job Description

About the Role
Title: Claims Processing Associate
Location:
Plano United States
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
Toggling back and forth between screens/can you navigate multiple systems.
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