Medical Claims Examiner, Remote

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 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 Requirements: * 3 year(s) hands-on experience in Healthcare Claims Processing * 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools• High school diploma or GED. * Previously performing - in P&Q work environment; work from queue; remotely * Key board skills and computer familiarity - o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products - Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: * Amisys * 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

Created: 2026-04-19