Req ID: 306599

NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now.

We are currently seeking a HC and Insurance Operations Analyst to join our team.

Position: Claims Case Manager

Pay: $22.00/hr

This position is eligible for company benefits including medical, dental, and vision insurance with an employer contribution, flexible spending or health savings account, life and AD&D insurance, short- and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.

• End-to-End Claim Management: Handle every aspect of the claim process, from intake to final decision.
• Status Updates: Provide frequent updates to claimants through their preferred communication channels.
• Document Review: Thoroughly review medical documents, claim forms, and policy notes.
• Communication: Interact with claimants with empathy and attention to detail.
• Team Collaboration: Work with team members to ensure high-quality service and resolution of issues.
• Record Keeping: Maintain accurate records and reports throughout the claims process.
• Data Analysis: Compile and analyze data to identify trends and perform root cause analysis.

• Experience:
  • 2 years in an analytical role reviewing medical benefits and claims.
  • 2 years of claims adjudication experience, preferably in life, annuity, and supplemental products (e.g., critical illnesses such as cancer, stroke, heart attack, kidney disease).
  • 4 years of experience reviewing and assessing medical records.
  • Experience articulating claim requirements clearly and concisely.
• Education: Minimum high school diploma or GED; college degree preferred.
• Work Environment:
  • At least 1 year of experience working from home with proven productivity and quality.
  • Designated quiet area for completing calls.

• Claim Initiation: Gather information and initiate claims through various channels.
• Detailed Logging: Log and update pertinent information throughout the claim lifecycle.
• Omni-Channel Correspondence: Communicate required medical records and claim information via email, mail, and phone.
• Proactive Follow-Up: Follow up on pending claims and assist in gathering required medical records.
• Benefit Calculation: Calculate benefit amounts and process payments through the claims system.
• Fraud Detection: Identify and flag potential fraudulent activities.
• Multitasking: Manage a caseload of active claims and perform end-to-end steps.
• Attention to Detail: Ensure accuracy and organization in logging, tracking, and reviewing claims.
• Collaboration: Work with management and team members to address service issues and concerns.
• Empathy: Communicate with claimants with empathy and a willingness to help.