Role Overview
NTT DATA is hiring a Claims Processing Associate to join our remote team. This role focuses on processing professional healthcare claim forms, reviewing policies and benefits, ensuring compliance with HIPAA regulations, and adjudicating claims within defined service-level agreements.
Key Responsibilities
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Process professional claim forms submitted by providers.
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Review benefits and policies for accuracy.
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Comply with HIPAA, PHI, and company confidentiality standards.
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Complete compliance training on time.
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Independently research and resolve claims.
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Prioritize and adjudicate claims within turnaround times/SLAs.
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Ensure claims follow client workflows and guidelines.
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Maintain productivity/quality targets (98.5% PA, 99.75% FA).
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Respond promptly to claim-related emails.
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Calculate payable claim amounts using approved methodologies/fee schedules.
Requirements
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1–3 years of hands-on experience in healthcare claims processing.
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2+ years using Windows applications and navigating multiple systems.
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High school diploma or GED.
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Proficiency in MS Office (Word, Excel, Outlook, Teams).
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Ability to work 7 AM – 4 PM CST remotely.
Preferred:
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Experience with Amisys.
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Strong communication (oral/written) in a professional setting.
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Research, analysis, and troubleshooting skills.
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Ability to manage time effectively in a changing environment.
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Prior experience working in productivity/quality-driven environments.
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Strong keyboarding and system navigation skills.
About NTT DATA
NTT DATA is a $30B+ global innovator in business and technology services, serving 75% of Fortune Global 100 companies. With operations in over 50 countries, we specialize in consulting, data & AI, industry solutions, infrastructure, and digital transformation. We are committed to diversity, inclusion, and equal opportunity for all employees.