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Claims Examiner

Company: NTT Data Inc
Location: Plano
Posted on: April 18, 2019

Job Description:

Req ID: 47378



At NTT DATA Services, 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 Services and for the people who work here.



NTT DATA Services currently seeks a Claims Examiner to join our team in Plano, Texas (US-TX), United States (US).





In these roles you will be responsible for:

* Analyzing and processing claims transactions in accordance with plan provisions
* Adjudicating claims based on your knowledge of covered benefits, insurance and provider contracts
* Determining plan liability as well as diversion and recovery activity for claims
* Ensuring customer satisfaction and strive to meet service standards
* Collaborating with management or other team members as appropriate to proactively address service issues and concerns
* Working with staff to resolve questions
* Working with team lead and audit team on audit findings

Required Skills for this role include:
* 2+ year(s) of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
* 1+ years of processing medical claims or enrollment processing
* 2+ years(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
* 2+ years of experience where you had to apply business rules to varying fact situations and make appropriate decisions
* 2+ years of experience that required prioritizing your workload to meet deadlines
* An education level of at least a high school diploma or GED
* Communicating effectively and professionally with both internal and external customers to resolve questions and issues
* Collaborating with management or other team members as appropriate to proactively address service issues and concerns

Preferred Skills for this role include:
* 2+ year(s) of experience in the healthcare industry that required medical claims coding knowledge with CPT, HCPCS, ICD9/10, CDT or member enrollment functions
* 1+ year(s) of experience with individual and group supplemental products, including Medicare supplements, limited benefit medical, dental/vision, critical illness and voluntary benefit plans.

*** All new hires will be required to successfully complete our training classes and demonstrate proficiency of the material ***



This position is only available to those interested in direct staff employment opportunities with NTT DATA, Inc. or its subsidiaries. Please note, 1099 or corp-2-corp contractors or the equivalent will NOT be considered. We offer a full comprehensive benefits package that starts from your first day of employment.



About NTT DATA Services



NTT DATA Services partners with clients to navigate and simplify the modern complexities of business and technology, delivering the insights, solutions and outcomes that matter most. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services.



NTT DATA Services, headquartered in Plano, Texas, is a division of NTT DATA Corporation, a top 10 global business and IT services provider with 118,000+ professionals in more than 50 countries, and NTT Group, a partner to 88 percent of the Fortune 100. Visit nttdataservices.com to learn more.



NTT DATA, Inc. (the Company ) is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other class protected by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.

Keywords: NTT Data Inc, Dallas , Claims Examiner, Other , Plano, Texas

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