Medical Claims Processor, Remote (Plano, TX, 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 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 Apply tot his job Apply To this Job