Medical Claims Processor

4 weeks ago


MO United States NTT DATA Full time
Job Title: Medial Claims Processor Industry: Healthcare FSLA status: Non-Exempt Department: Operations Level: Entry to mid-level Location: Work at Home Pay Rate: 17.00-18.00

In this Role the candidate will be responsible for:
  • Processing of Professional and Hospital 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/ fee schedule/

Required Skills for this role include:

  • 2+ year(s) of Medical Claims experience
  • 2+ year(s) using a computer with Windows applications that required you to use a keyboard, navigate multiple screens and computer systems, and learn new software tools
  • 1+ years of working with Claims Adjudication Systems
  • High School diploma or equivalent


Preference

  • Ability to communicate (oral/written) effectively in a professional office setting


  • Effective troubleshooting skills where you can leverage your research, analysis and problem-solving skills


  • Time management skills that require the ability to cope with a complex, changing environment


Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is $17.00-18.00. 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. This position may also be eligible for incentive compensation based on individual and/or company performance.

This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits. #INDHRS

  • , MO, United States NTT DATA Full time

    NTT DATA's Client is seeking a Remote Claims Processing Associate to join their team!*Must be able to work Monday to Friday 7 AM to 4 PM Central time.In this Role the candidate will be responsible for: Processing of Professional and Hospital claim forms files by provider Reviewing the policies and benefits• Comply with company regulations regarding HIPAA,...

  • Claims Processor

    2 months ago


    South Sioux City, NE, United States Great West Casualty Company Full time

    Be part of a team where every day you make a difference! We are looking for a new Claims Processor who will provide exceptional customer service.As a Claims Processor, you will take the first reports of accidents and initiate the claims investigation process. This position is the front line of our claims department and is crucial in setting the tone for...

  • Claims Processor

    2 weeks ago


    South Sioux City, NE, United States Great West Casualty Company Full time

    Be part of a team where every day you make a difference! We are looking for a new Claims Processor who will provide exceptional customer service.As a Claims Processor, you will take the first reports of accidents and initiate the claims investigation process. This position is the front line of our claims department and is crucial in setting the tone for...


  • , MI, United States Labcorp Full time

    Job Summary:Labcorp is seeking a skilled Healthcare Billing Specialist to join our Revenue Cycle Management Division in Detroit, MI. As a key member of our team, you will be responsible for ensuring accurate and timely billing and reimbursement for our clients.Responsibilities:Verify patient insurance coverage and obtain pre-authorization for scheduled...

  • Claims Processor

    2 weeks ago


    Houston, TX, United States American Risk Insurance Company Full time

    Exciting Opportunity in Houston! We are a rapidly growing insurance company based in the Southwest Houston/Galleria Area, catering to home and commercial property insurance clients in Texas. We want to add several members to our Claims and Customer Service departments. No prior experience is needed. We will provide all the training and even help you get...

  • Claims Analyst 1

    2 weeks ago


    Wichita, KS, United States TEKsystems Full time

    Job Description • Learn how to research why medical claims are stuck in the Pre-Payment Review Database. (PPRD) and clear the issue such as a member match problem so the claim can go to a trained Claims Analyst for adjudication. Will train as claims processor if PPRD training and work is at quality and production standard within 4 months.Additional Skills...

  • Specimen Processor

    1 month ago


    Harrisburg, PA, United States UPMC - Pittsburgh Medical Center Full time

    Job DescriptionIf you are looking for an opportunity to support quality patient care in an important behind-the-scenes role, this Specimen Processor opening is for you!  UPMC Harrisburg is hiring a full-time Specimen Processor for their day shift team. This role organizes patient specimens collected by the phlebotomy team, prepares specimens for analysis or...

  • Specimen Processor

    1 month ago


    Pittsburgh, PA, United States UPMC - Pittsburgh Medical Center Full time

    Job DescriptionAre you someone with customer service, retail distribution, or similar experience looking to get into the medical field but unsure where to start? An entry-level role as a Specimen Processor in the UPMC laboratories may be your perfect next step!  UPMC Presbyterian is hiring a casual Specimen Processor (per diem) to support the Automated...

  • Specimen Processor

    3 weeks ago


    Pittsburgh, PA, United States UPMC - Pittsburgh Medical Center Full time

    Job DescriptionAre you someone with customer service, retail distribution, or similar experience looking to get into the medical field but unsure where to start? An entry-level role as a Specimen Processor in the UPMC laboratories may be your perfect next step!  UPMC Presbyterian is hiring a full-time Specimen Processor to support the Automated Testing...

  • Specimen Processor

    4 days ago


    Cumberland, MD, United States UPMC - Pittsburgh Medical Center Full time

    Job DescriptionUPMC Western Maryland is hiring a Part-time Specimen Processor to support their Lab! The Specimen Processor's role is to receive, sort, identify, process, and distribute specimens to all technical sections. Enter requisition information and patient results into the computer system; call statistical results, answer phones, code charge slips,...


  • Fresno, CA, United States TEKsystems Full time

    Description:The Claims Examiner I reports to the Superviosr of Claims. Claims Examiner I is responsible for reviewing and processing medical, dental, vision and electronic claims in accordance with state, federal and health plan regulatory requirements, department guidelines, as well as meet established quality and production performance benchmarks to...

  • Specimen Processor

    3 weeks ago


    Harrisburg, PA, United States UPMC - Pittsburgh Medical Center Full time

    Job DescriptionIf you are looking for an opportunity to support quality patient care in an important behind-the-scenes role, this Specimen Processor opening is for you!  UPMC Harrisburg is hiring a full-time flex Specimen Processor for their evening shift team. This role organizes patient specimens collected by the phlebotomy team, prepares specimens for...

  • Specimen Processor

    5 days ago


    Carlisle, PA, United States UPMC - Pittsburgh Medical Center Full time

    Job DescriptionIf you are looking for an opportunity to support quality patient care in an important behind-the-scenes role, this Specimen Processor opening is for you!  UPMC Carlisle is looking for a full time Specimen Processor to join their team! This role organizes patient specimens collected by the phlebotomy team, prepares specimens for analysis or...

  • Plasma Processor

    4 weeks ago


    MO-Independence, United States GRIFOLS, S.A. Full time

    table.MiTabla { max-width: 1020px;!important Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of people around the world. We are leaders...

  • Plasma Processor

    2 weeks ago


    MO-Kansas City, United States GRIFOLS, S.A. Full time

    table.MiTabla { max-width: 1020px;!important Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of people around the world. We are leaders...

  • Specimen Processor

    1 month ago


    Erie, PA, United States UPMC - Pittsburgh Medical Center Full time

    Job DescriptionUPMC welcomes your application to join our team as a Specimen Processor!  This full-time role features hours from 4am to 12:30pm, with rotating shifts on weekends and holidays. Apply today to join a great team and receive a robust Totals Reward package!! Responsibilities: Demonstrate exceptional service orientation by consistently showing...


  • Covington, KY, United States Molina Healthcare Full time

    Job DescriptionJOB DESCRIPTIONJob SummaryUtilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding...

  • Plasma Processor

    3 weeks ago


    MO-Cape Girardeau, United States GRIFOLS, S.A. Full time

    table.MiTabla { max-width: 1020px;!important Would you like to join an international team working to improve the future of healthcare? Do you want to enhance the lives of millions of people? Grifols is a global healthcare company that since 1909 has been working to improve the health and well-being of people around the world. We are leaders...

  • Cash Processor

    1 month ago


    Pittsburgh, PA, United States Brink's Full time

    Overview: Job DescriptionThe Brink's name is a promise to respect the trust we've earned in over 150 years in business. Every employee honors that promise by offering the highest levels of service and support to our customers. We take pride in our work, and we share a passion about our future. Learn why so many people have made the choice to join our team -...

  • Specimen Processor

    1 week ago


    Monroeville, PA, United States UPMC - Pittsburgh Medical Center Full time

    Job DescriptionHave you always wanted to get your healthcare career started?  Are you interested in a position that offers terrific benefits and opportunities to grow?  Do you enjoy working "hands on" in a team environment?  Then you may be a perfect fit for our role in the Lab Testing department with UPMC East. UPMC East is currently hiring a fulltime...