Medical Claims Processor-Remote at NTT DATA summary:
The Medical Claims Processor is responsible for processing professional claim forms, reviewing policies and benefits, and ensuring compliance with regulations such as HIPAA. This remote role requires at least two years of experience in medical claims processing along with skills in VBA or HealthRules. The position demands high productivity and quality standards, maintaining quality scores above 98.5% for professional accuracy and 99.75% for financial accuracy.
NTT DATA's Client is seeking a Remote Claims Processor to join their team for a 3+ month contract role.
MUST HAVE VBA OR HRP EXPERIENCE!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
Required:
• 2+ years of experience in medical claims processing
• 1+ year of experience with VBA or HRP
• High school diploma or GED
Preferred:
• 1+ year of experience with HealthRules
#INDHRS
NTT DATA Services 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 - 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.
Keywords:
medical claims processing, HIPAA compliance, VBA programming, claims adjudication, healthcare claims, remote healthcare jobs, HealthRules, claims processing software, quality assurance, professional claim forms