About the position
Responsibilities
• 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
Requirements
• 2+ years of experience in medical claims processing
• 1+ year of experience processing claims with HealthRules or Visual Basic
• High school diploma or GED
Benefits
• Remote work opportunity
• Competitive hourly wage of $18 - $24
• Diverse and inclusive work environment
• Opportunities for professional development
Apply Now
Apply Now