NTT DATA's Client is seeking a Remote Claims Processing Associate to join their team!
In this Role the candidate will be responsible for:
- Processing of Professional claim forms files by provider
- Reviewing the policies and benefits
• 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.
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• 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 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.
- 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
In this Role the candidate will be responsible for:
- Processing of Professional claim forms files by provider
- Reviewing the policies and benefits
• 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 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.
- 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
In this Role the candidate will be responsible for:
- Processing of Professional claim forms files by provider
- Reviewing the policies and benefits
• 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 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.
- 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