Sign up with

Already have an account? Log in here

Need some help?
Talk to us at +91 7670800001

HC & Insurance Operations Processing Sr Rep at NTT DATA

Plano, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

03 Jul, 26

Salary

0.0

Posted On

04 Apr, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Claims processing, Healthcare claims, HIPAA compliance, Data entry, Microsoft Outlook, Microsoft Word, Microsoft Excel, Amisys, Troubleshooting, Research, Analysis, Problem-solving, Time management, Communication, Adjudication

Industry

IT Services and IT Consulting

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 – o Toggling back and forth between screens/can you navigate multiple systems. o 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

Responsibilities

The candidate will be responsible for processing professional claim forms, reviewing policies and benefits, and ensuring all work complies with HIPAA and client-defined workflows. They must also maintain high quality and productivity standards while resolving claims received via email.