Req ID: 105120

NTT DATA Services 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 Remote Claims Adjudicator - Temp to join our team in Tampa, Florida (US-FL), United States (US).

In this Role you will be Responsible for :

* Reviewing and researching insurance claims to determine possible payment accuracy.
* Validating Member, Provider and other Claims information.
* Determining accurate payment criteria for clearing pending claims based on defined Policy and Procedure.
* Coordinating Claim Benefits based on the Policy & Procedure.
* Maintaining productivity goals, quality standards and aging timeframes.
* Scrutinizing Medical Claim Documents and settlements.

Requirements for this role include :
* 1+ years of Claims Adjudication experience that required you to review claims rules and workflows.
* 1+ years of experience processing claims that required a working knowledge of HCPCS, ICD and CPT codes
* 1+ years of experience that required a knowledge of healthcare insurance policy concepts including In Network, Out of Network providers, Deductible, Coinsurance, Co-pay, Out of Pocket, Maximum inside limits and Exclusions, State Variations.

Desired Skills:
* Prior experience with Xcelys and/or Amisys software system(s)

*This position is 100% remote*

About NTT DATA Services

NTT DATA Services is a global business and IT services provider specializing in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. We are part of the NTT family of companies, a partner to 85 % of the Fortune 100.

NTT DATA Services is an equal opportunity employer and will consider all qualified applicants for employment without regard to race, gender, disability, age, veteran-status, sexual orientation, gender identity, or any other class protected by law.