NTT

1 month ago

Claims Examiner Remote

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Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 4 hours agoStatus: Live

Job Summary

Review and process health insurance claims for a U.S. client, validating member and provider information and determining accurate payment criteria based on policy and procedure. Coordinate claim benefits, scrutinize medical claim documents, and resolve complex situations using established guidelines while maintaining productivity, quality standards, and aging timeframes. Maintain fluency in healthcare insurance products and processes, prioritize assigned work, and meet Monday–Friday shift requirements.

Location: Plano

Workplace: Remote

Employment Type: Full time

Job Function: Insurance & Actuarial

Key Responsibilities

•Review and process insurance claims.
•Validate member, provider, and claim information.
•Determine accurate payment criteria and coordinate claim benefits based on policy and procedure.
•Scrutinize medical claim documents, settlements, and resolve complex situations using guidelines.
•Maintain productivity goals, quality standards, and aging timeframes while organizing assigned priorities.

Key Requirements

•University degree or equivalent with formal studies of English and basic Math.
•6+ months of experience applying business rules to varying fact situations and making appropriate decisions.
•6+ months of data entry experience focused on quality, attention to detail, accuracy, and accountability.
•6+ months of experience using a Windows PC with keyboard navigation and learning new software tools.
•6+ months of experience prioritizing workload to meet deadlines.

Skills:Attention to detailAccuracyAccountabilityWork prioritizationCommunication

Languages:English

Tech Stack:WindowsPC applications

Company Brief

NTT

Dimension Data, operating under NTT Ltd, provides managed IT services, cloud and data center solutions, networking, cybersecurity, and digital transformation services to enterprise customers worldwide.

Industry: Professional Services

Company Size: Enterprise (1,001+ employees)

Revenue: USD 1B+

Growth: Established Company

Valuation: Public Company (Market Cap in USD)

Headquarters: London, United Kingdom

Founded: 1983

Website LinkedIn

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NTT