Medical Claims Specialist

6 days ago


Providence, Rhode Island, United States NTT DATA Full time

About the Role:

The Medical Claims Specialist will be responsible for taking in-bound calls from members, providers, and other stakeholders, providing professional phone assistance to all callers through the criteria-based prior authorization process.

Key Responsibilities:

  • Effectively manage work volume by handling inbound calls, fax, and ePA requests
  • Comply with departmental, company, state, and federal requirements when processing all information to ensure accuracy of information being provided to internal and external customers
  • Communication with other internal groups regarding determination status and results (nurses, pharmacists, medical staff)

Requirements:

  • 3+ years of related work experience
  • 1+ years of Prior authorization experience
  • 3+ year of data entry experience
  • 1+ years of customer service experience in a high-volume environment

PREFERRED QUALIFICATIONS:

  • Strong Attention to detail
  • Excellent verbal and written communication and interpersonal skills with ability to maintain patient confidentiality
  • Proficient computer skills and the ability to navigate in a Windows-based environment
  • Ability to follow directions, and adapt in dynamic work environment; ability to adapt to change and remain flexible

Additional Information:

This is a remote role with an estimated start date of February 17th. The starting hourly range for this position is $18.20. NTT DATA is an equal opportunity employer and considers all applicants without regard to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law.



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