HC & Insurance Operations Processing Sr Rep

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 and institutional claims
•  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
•  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 or Xcelys
•  Medicaid and Medicare Claims processing experience
•  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