Remote Claims Processing Associate

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
Complying with company regulations regarding HIPAA, confidentiality, and PHI
Abiding with the timelines to complete compliance training of NTT Data/Client
Working independently to research, review and act on the claims
Prioritizing work and adjudicating claims as per turnaround time/SLAs
Ensuring 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 calculating 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 –

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

HC & Insurance Operations Processing Sr Rep - Remote Eligible