Claims Examiner

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