Job Description
This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description NTT DATA currently seeks a Medical Claims Processor to join our team in Plano, TX for a remote position. This is a US based; W-2 project. All candidates will be paid through NTT DATA only. • 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 • 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 Qualifications • 1+ year(s) hands-on experience in Healthcare Claims Processing • Previously performing - in P&Q work environment; work from queue; remotely • 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools • Working knowledge of MS office products - Outlook, MS Word and MS-Excel • Typing and Computer skills assessment Requirements • 3 year(s) hands-on experience in Healthcare Claims Processing • 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 Benefits • 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 • Additional voluntary or legally required benefits Apply tot his job