Claims Examiner

Claims Examiner

NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Claims Examiner to join our team in Plano, Texas (US-TX). In this role, the candidate will be responsible for :

• Processing of professional claim forms files by provider
• Reviewing the policies and benefits
• Complying with company regulations regarding HIPAA, confidentiality, and PHI
• Abiding with the timelines to complete compliance training of NTT Data / Client
• Working independently to research, review and act on the claims
• Prioritizing work and adjudicating claims as per turnaround time / SLAs
• Ensuring 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 calculating claims payable amount using applicable methodology / fee schedule

Requirements :

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. 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 one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future.

NTT DATA recruiters will never ask for payment or banking information and will only use @nttdata.com and @talent.nttdataservices.com email addresses. If you are requested to provide payment or disclose banking information, please submit a contact us form at https : / / us.nttdata.com / en / contact-us.

NTT DATA endeavors to make https : / / us.nttdata.com accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at https : / / us.nttdata.com / en / contact-us. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.