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Claims processing at NTT DATA

Plano, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

09 Mar, 26

Salary

0.0

Posted On

09 Dec, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims Processing, Insurance Claims, Medical Claim Documents, Productivity Goals, Quality Standards, Healthcare Insurance, Policy and Procedure, Task Organization, Complex Situation Resolution

Industry

IT Services and IT Consulting

Description

In these roles you will be responsible for: Review and process insurance claims. Validate Member, Provider and other Claim's information. Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure. Coordination of Claim Benefits based on the Policy & Procedure. Maintain productivity goals, quality standards and aging timeframes. Scrutinizing Medical Claim Documents and settlements. Organizing and completing tasks per assigned priorities. Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Resolving complex situations following pre-established guidelines

Responsibilities

The role involves reviewing and processing insurance claims while validating member and provider information. Additionally, it requires determining payment criteria and maintaining productivity and quality standards.