NTT DATA North America
Medical Claims Processor — Remote (Plano, TX) at NTT DATA North America. Join our team to process medical claims, work W‑2, paid via NTT DATA.
Job Summary NTT DATA, a global leader in technology services, is seeking a Medical Claims Processor to support our clients in the healthcare domain. The role includes reviewing and adjudicating professional claims, ensuring compliance with HIPAA and other regulations, and maintaining high quality scores.
Key Responsibilities
Process professional claim form files provided by the provider.
Review policies and benefits.
Comply with company regulations regarding HIPAA, confidentiality, and PHI.
Complete compliance training within specified timelines.
Research, review, and act on claims independently.
Prioritize work and adjudicate claims per turnaround time/SLAs.
Adjudicate claims following client‑defined workflows and guidelines.
Sustain client productivity and quality targets to avoid penalties.
Maintain quality scores above 98.5% PA and 99.75% FA.
Respond to and resolve claims received via email in a timely manner.
Calculate claims payable amounts using applicable methodology and fee schedule.
Troubleshoot issues leveraging research, analysis, and problem‑solving skills.
Manage time effectively in a complex, changing environment.
Communicate effectively, both orally and in writing, in a professional office setting.
Required Skills & Experience
Minimum one year of hands‑on experience in Healthcare Claims Processing, preferably in a P&Q work environment.
Two or more years of experience using Windows applications, navigating multiple screens, and learning new software tools.
Strong keyboard skills and familiarity with multiple computer systems.
Proficiency in MS Office products – Outlook, Word, Excel.
Ability to toggle between screens and navigate multiple systems.
Preferred Experience
Experience with Amisys and/or Xcelys preferred.
Compensation Hourly rate $18.00 per hour. Eligible for company benefits including medical, dental, vision insurance, 401(k) with company match, paid time off, employee assistance, and additional voluntary or legally required benefits.
Employment Details US‑based, W‑2 project; remote; location: Plano, TX with remote option.
EEO Statement NTT DATA is an equal opportunity employer and considers all applicants without regard to race, color, religion, citizenship, national origin, age, sex, sexual orientation, gender identity, genetic information, disability, veteran status, or marital status. If you need an accommodation due to a disability, please inform your recruiter.
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Job Summary NTT DATA, a global leader in technology services, is seeking a Medical Claims Processor to support our clients in the healthcare domain. The role includes reviewing and adjudicating professional claims, ensuring compliance with HIPAA and other regulations, and maintaining high quality scores.
Key Responsibilities
Process professional claim form files provided by the provider.
Review policies and benefits.
Comply with company regulations regarding HIPAA, confidentiality, and PHI.
Complete compliance training within specified timelines.
Research, review, and act on claims independently.
Prioritize work and adjudicate claims per turnaround time/SLAs.
Adjudicate claims following client‑defined workflows and guidelines.
Sustain client productivity and quality targets to avoid penalties.
Maintain quality scores above 98.5% PA and 99.75% FA.
Respond to and resolve claims received via email in a timely manner.
Calculate claims payable amounts using applicable methodology and fee schedule.
Troubleshoot issues leveraging research, analysis, and problem‑solving skills.
Manage time effectively in a complex, changing environment.
Communicate effectively, both orally and in writing, in a professional office setting.
Required Skills & Experience
Minimum one year of hands‑on experience in Healthcare Claims Processing, preferably in a P&Q work environment.
Two or more years of experience using Windows applications, navigating multiple screens, and learning new software tools.
Strong keyboard skills and familiarity with multiple computer systems.
Proficiency in MS Office products – Outlook, Word, Excel.
Ability to toggle between screens and navigate multiple systems.
Preferred Experience
Experience with Amisys and/or Xcelys preferred.
Compensation Hourly rate $18.00 per hour. Eligible for company benefits including medical, dental, vision insurance, 401(k) with company match, paid time off, employee assistance, and additional voluntary or legally required benefits.
Employment Details US‑based, W‑2 project; remote; location: Plano, TX with remote option.
EEO Statement NTT DATA is an equal opportunity employer and considers all applicants without regard to race, color, religion, citizenship, national origin, age, sex, sexual orientation, gender identity, genetic information, disability, veteran status, or marital status. If you need an accommodation due to a disability, please inform your recruiter.
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