NTT

1 month ago

Claims Examiner Remote

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Source: Company careers pageValidated by: Fursa AI

Last checked: 4 hours agoStatus: Live

Job Summary

Process and review health insurance claims for an end-to-end claims administration BPO operation. Validate member, provider, and claim information, determine accurate payment criteria, coordinate claim benefits per policy, and scrutinize medical claim documents and settlements. Maintain productivity, quality, and aging targets while resolving complex issues using established guidelines and developing strong knowledge of healthcare insurance products and processes.

Location: Plano

Workplace: Remote

Employment Type: Full time

Job Function: Insurance & Actuarial

Seniority: Entry level

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.
•Maintain productivity goals, quality standards, and aging timeframes.
•Scrutinize medical claim documents and settlements and resolve complex situations using established guidelines.

Key Requirements

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

Experience:InsuranceHealthcare

Education:

Skills:Attention to detailAccuracyCommunicationWorkload prioritization

Languages:English

Tech Stack:WindowsData entry

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