TEMP BPO Senior Representative

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company’s growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.

NTT DATA currently seeks a Medical Claims Processor to join our team in Plano, TX for a remote position.

This is a US based; W-2 project. All candidates will be paid through NTT DATA only.

Role Responsibilities

-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

-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

-Ability to communicate (oral/written) effectively in a professional office setting

Required Skills/Experience  

Preferences

Amisys &/or Xcelys Preferred

NTT Data Services is Hiring!

Position's Overview

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company’s growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.

NTT DATA, Inc. currently seeks a BPO HC & Insurance – Claims Associate to join our team.

Client's business problem to solve?

Our Client is one of the leading Health Plans in the US providing services in multiple states. NTT Business Process Outsourcing (BPO) team offers end-to-end administrative services help streamline operations, improve productivity, and strengthen cash flow to help our customers stay competitive and improve member satisfaction.

Position's General Duties and Tasks

• Process claims by following the policies and procedures as defined by the customer.

• Take up additional trainings/ new assignments or projects that may come up as per client needs.

• Meet/ exceed required performance measures such as quality and productivity standards

• Meet/ exceed process SLAs

• Confirm to the required regulatory and compliance requirements such as the HIPAA.

• Confirm to the organizational and client training requirements

• Understand how work impacts results for their area as well as other processes.

• Demonstrate knowledge of internal operations and develops relationships to facilitate workflow.

• Knowledge of related regulations and standards.

• Strong understanding of current processes and procedures and may identify opportunities for improvement.

Requirements for this role include:

• High school Diploma or equivalent.

• 3+ years of medical claims processing experience

• Experience in Amisys preferred

• 5+ years of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, leverage internet search engines, and other web based applications.

• 5+ years of experience with the Microsoft Office suite that required daily usage of Outlook, Excel and Word.

• Ability to type 40 WPM

Required schedule availability for this position is Monday-Friday (08:00am to 08:00pm CST/EST) . The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend’s basis business requirement.

Position's General Duties and Tasks:

Process claims by following the policies and procedures as defined by customer. Take up new assignments or projects that may come up as per clients needs. Meet/exceed required performance measures such as quality and productivity standards. Meet/Exceed process SLA's. Understand how work impacts results for their area as well as other processes. Demonstrate knowledge of internal operations. Knowledge of related regulations and standards.

Position's General Duties and Tasks: Process claims by following the policies and procedures as defined by customer. Take up new assignments or projects that may come up as per clients needs. Meet/exceed required performance measures such as quality and productivity standards. Meet/Exceed process SLA's. Understand how work impacts results for their area as well as other processes. Demonstrate knowledge of internal operations. Knowledge of related regulations and standards.

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 hourly range for this remote role is $18.00/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.

This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, 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.