Posted in Other 30+ days ago.
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Type: Full Time
Location: Tampa, Florida
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.
* 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.