Claims Processing Associate w/systems exp: VBA & HealthRules - REMOTE
NTT DATA's Client is seeking a Remote Claims Processing Associate to join their team; must-have experience in the systems/software - VBA and HealthRules (HRP).
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
Required Skills for this role include:
1-3 year(s) of hands-on experience in Healthcare Claims Processing
Must have experience in software: VBA or HRP
2+ year(s) using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools
An education level of at least a high school diploma or GED.
Understanding of previous quality, production and attendance parameters
Understanding and adhering to working hours and leave policy.
Key board skills and computer familiarity
Familiar with toggling back and forth between screens/can you navigate multiple systems.
Working knowledge of MS office products like Outlook, MS word and MS-excel.
Preference
Ability to communicate (oral/written) effectively in a professional office setting
Effective troubleshooting skills where you can leverage your research, analysis and problem-solving skills
Time management skills that require the ability to cope with a complex, changing environment
About NTT DATA
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com .
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting range for this remote role is ($18.00 - $22.00 Hourly). This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
Apply Now
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
Required Skills for this role include:
1-3 year(s) of hands-on experience in Healthcare Claims Processing
Must have experience in software: VBA or HRP
2+ year(s) using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools
An education level of at least a high school diploma or GED.
Understanding of previous quality, production and attendance parameters
Understanding and adhering to working hours and leave policy.
Key board skills and computer familiarity
Familiar with toggling back and forth between screens/can you navigate multiple systems.
Working knowledge of MS office products like Outlook, MS word and MS-excel.
Preference
Ability to communicate (oral/written) effectively in a professional office setting
Effective troubleshooting skills where you can leverage your research, analysis and problem-solving skills
Time management skills that require the ability to cope with a complex, changing environment
About NTT DATA
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com .
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting range for this remote role is ($18.00 - $22.00 Hourly). This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
Apply Now