Claims Examiner RemoteNTT DATA Services is seeking a Claims Examiner Remote to join our team in Plano, Texas (US-TX), United States (US). 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 providerReviewing the policies and benefitsComplying with company regulations regarding HIPAA, confidentiality, and PHIAbiding with the timelines to complete compliance training of NTT Data/ClientWorking independently to research, review, and act on the claimsPrioritizing work and adjudicating claims as per turnaround time/SLAsEnsuring claims are adjudicated as per clients defined workflows, guidelinesSustaining and meeting the client productivity/quality targets to avoid penaltiesMaintaining and sustaining quality scores above 98.5% PA and 99.75% FATimely response and resolution of claims received via emails as priority workCorrectly calculating claims payable amount using applicable methodology/fee scheduleRequirements:3 year(s) hands-on experience in Healthcare Claims Processing2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software toolsHigh school diploma or GED.Previously performing – in P&Q work environment; work from queue; remotelyKey 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:AmisysAbility to communicate (oral/written) effectively in a professional office settingEffective troubleshooting where you can leverage your research, analysis, and problem-solving abilitiesTime management with the ability to cope in a complex, changing environmentAbout NTT DATA:NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100.
We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers, and application services. Our consulting and industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries.
We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D. Whenever possible, we hire locally to NTT DATA offices or client sites. This ensures we can provide timely and effective support tailored to each client's needs.
While many positions offer remote or hybrid work options, these arrangements are subject to change based on client requirements. For employees near an NTT DATA office or client site, in-office attendance may be required for meetings or events, depending on business needs. At NTT DATA, we are committed to staying flexible and meeting the evolving needs of both our clients and employees.