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HC & Insurance Operations Processing Sr Rep
Veterans StaffingPlano, TX, US30+ days ago
Job type
- Full-time
Job description3 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 Toggling back and forth between screens / can you navigate multiple systems. Working knowledge of MS office products Outlook, MS Word and MS-Excel. 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
Remote Claims Processing Associate
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 :
Preferred Skills & Experiences :
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Insurance Rep • Plano, TX, US