Medical Claims Processor – United States, REMOTE | NTT DATA North America

Company Overview:

NTT DATA North America is seeking a Remote Medical Claims Processor to support healthcare claims processing operations for its client team, offering ideal opportunities for candidates experienced in healthcare claims processing.

Job Description:

The Medical Claims Processor – Remote will review and process professional claim forms, verify policies and benefits, calculate payable amounts, and ensure claims are handled according to client guidelines and service level requirements.

Key Responsibilities:

• Process professional healthcare claim forms submitted by providers.
• Review insurance policies, benefits, and applicable claim details.
• Research, analyze, and resolve claims independently while following defined workflows.
• Adjudicate claims according to client guidelines, turnaround times, and service level agreements.
• Calculate claim payable amounts using applicable methodologies and fee schedules.
• Maintain compliance with HIPAA, confidentiality requirements, and protected health information (PHI) regulations.
• Respond to claims-related emails and resolve priority requests in a timely manner.
• Maintain required productivity and quality standards.
• Complete required compliance training within specified timelines.

Requirements:

• 1–3 years of experience in Healthcare Claims Processing.
• High School Diploma or GED.
• Experience working with computer systems, multiple screens, and software applications.
• Ability to navigate multiple systems and perform accurate data processing.
• Working knowledge of Microsoft Office products, including Outlook, Word, and Excel.
• Experience working remotely in a productivity and quality-focused environment.
• Strong troubleshooting, research, analytical, and problem-solving skills.
• Excellent time management skills with the ability to work in a changing environment.
• Strong written and verbal communication skills.
• Ability to work remotely from 7:00 AM to 4:00 PM CST, including required on-camera training.

What We Offer:

• Competitive hourly salary of $18/hour.
• 100% remote work environment with structured training.
• Professional growth opportunities within a leading healthcare solutions team.