Job Description
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NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team.<br><br>In this Role the candidate will be responsible for:<br><br><ul><li> Processing of Professional claim forms files by provider</li><li> Reviewing the policies and benefits</li><li> Comply with company regulations regarding HIPAA, confidentiality, and PHI</li><li> Abide with the timelines to complete compliance training of NTT Data/Client</li><li> Work independently to research, review and act on the claims</li><li> Prioritize work and adjudicate claims as per turnaround time/SLAs</li><li> Ensure claims are adjudicated as per clients defined workflows, guidelines</li><li> Sustaining and meeting the client productivity/quality targets to avoid penalties</li><li> Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA. </li><li> Timely response and resolution of claims received via emails as priority work</li><li> Correctly calculate claims payable amount using applicable methodology/ fee schedule<br><br></li></ul>Requirements:<br><br><ul><li> 3 year(s) hands-on experience in Healthcare Claims Processing</li><li> 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools</li><li> High school diploma or GED. </li><li> Previously performing – in P&Q work environment; work from queue; remotely</li><li> Key board skills and computer familiarity –</li><li> Toggling back and forth between screens/can you navigate multiple systems. </li><li> Working knowledge of MS office products – Outlook, MS Word and MS-Excel. <br><br></li></ul>Preferred Skills & Experiences:<br><br><ul><li> Amisys</li><li> Ability to communicate (oral/written) effectively in a professional office setting</li><li> Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities</li><li> Time management with the ability to cope in a complex, changing environment</li></ul>
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