Senior Medical Claims Examiner – NTT DATA Services – Uniontown, OH

NTT Data seeks a full time, direct hire Claims Examiner for our customer in Uniontown, OH.

** NTT Data is assisting our healthcare client with the recruiting efforts for this position. This is not a position with NTT DATA.**

GENERAL PURPOSE OF POSITION
It is the responsibility of the Claims Examiner to process medical/dental claims for healthcare services in accordance with Client’s benefit health plan provision.

ESSENTIAL RESPONSIBILITIES:

  • Receive incoming calls regarding insurance coverage and benefits, eligibility issues along with claim status.
  • Answer and return phone calls and emails from Client members. Return voice mail messages in accordance with organizational standards.
  • Accurately process medical / dental claims according to plan provisions, corporate policies and procedures.
  • Consistently meet production goals in accordance with organizational standards
  • Communicate systems issues promptly to the Claims Supervisor/Manager
  • Responsible for the management of all telephone calls and general correspondence received from members of our Client’s health plan
  • Demonstrate a positive and cooperative work attitude, encourage teamwork among fellow employees and customers.
  • Provide backup in other areas, based on business need, assisting management with special projects or requests.
  • Additional tasks as assigned by management.

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential responsibility satisfactorily. Additionally, these qualifications are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Must be able to serve medical insurance plan members and medical providers by determining insurance coverage including eligibility and claim status; examining and resolving medical claims.
  • Must have above average knowledge with claims adjustment / processing, financial software, documentation skills, data entry, analyzing information, problem solving, verbal and written

communication, customer focus, general math skills and statistical analysis.

  • Must be able to work independently, be organized and have the ability to multi-task.
  • Attendance is crucial to this position.

EDUCATION and/or EXPERIENCE: (Required)

  • Associates Degree
  • Minimum of three (3) years recent experience in processing medical claims.

PRODUCTION/QUALITY GOALS:

  • After a one-year training period, expectation is 150 claims paid daily. This percentage is based on industry standards.
  • Incoming calls received are taken into account and deducted from daily totals.

Benefits:

  • Medical/Dental/Vision – client pays 95% of the monthly premium, employee responsible for the other 5%. – i.e. monthly cost for single employee is $998 – client pays $949 Employee pays $49
  • Basic Life (paid by client)
  • Voluntary Life – employee paid
  • Short & Long Term Disability – employee paid. After 5 years of service, client covers Long Term premium
  • Critical Illness/Accident (supplemental policies) – employee paid
  • 401(k) option after 1 year of service with up to a 4% of annual salary match by client
  • PTO policy – 20 days or 4 weeks accrued for use during first two years of employment. Additional weeks earned with service maxing out at 7 weeks or 35 days of PTO.
  • Up to 15 paid holidays per year (in addition to PTO)
  • Discount programs
  • Employee Assistance Program

*This is not an NTT DATA position. NTT DATA is helping identify the ultimate candidate to present for this open opportunity with our customer hiring direct for a Claims Examiner in Uniontown, OH. However, the info below is related to NTT DATA should you want further information about careers within the company. https://us.nttdata.com/en/careers

Job Type: Full-time

Pay: $33,000.00 – $35,000.00 per year

Application Question(s):

  • What types of claims have you paid? (ie: COB, Medicaid, TPA, vision, dental, self-funded, etc.)
  • Have you had to meet production and quality standards in the past? If so, what were they, relative to claims processing and where (what employer)?
  • Have you been the person that actually PAID the claims “out the door”, so to speak?

Education:

  • Associate (Required)

Experience:

  • medical claims processing: 3 years (Required)

Work Location:

  • One location

Work Remotely:

Source: Indeed.com
Click Here To Apply

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