65 Claims Processing jobs in the United States

**Details**
+ **Department:** Billing and Claims
+ **Schedule:** Full-Time, Days Mon. - Fri. 8AM-5PM
+ **Hospital:** Ascension St. Vincent's
+ **Location:** 3 Shircliff Way Jacksonville, Florida United States
**Benefits**
Paid time off (PTO)
Various health insurance options & wellness plans
Retirement benefits including employer match plans
Long-term & short-term disability
Employee assistance programs (EAP)
Parental leave & adoption assistance
Tuition reimbursement
Ways to give back to your community
_Benefit options and eligibility vary by position. Compensation varies based on factors including, but not limited to, experience, skills, education, performance, location and salary range at the time of the offer._
**Responsibilities**
Prepare and issues bills for reimbursement to individual and third party payers in an out-patient or medical office environment.
+ Prepare insurance claims for submission to third party payers and/or responsible parties.
+ Review claims for accuracy, including proper diagnosis and procedure codes.
+ Review claim rejections and communicates with payers to resolve billing issues.
+ Prepare and review routine billing reports.
+ Recommend process improvements based on findings.
+ Respond to complex telephone and written inquiries from patients and/or third party payers and physician practices.
**Requirements**
Education:
+ High School diploma equivalency OR 1 year of applicable cumulative job specific experience required.
+ Note: Required professional licensure/certification can be used in lieu of education or experience, if applicable.
**Additional Preferences**
No additional preferences.
**Why Join Our Team**
Ascension St. Vincent's is expanding in the fastest-growing county in Northeast Florida with the addition of a fourth regional hospital, Ascension St. Vincent's St. Johns County. Serving Northeast Florida and Southeast Georgia, Ascension St. Vincent's has been providing caregivers in every discipline a rewarding career in healthcare since 1873.
Ascension is a leading non-profit, faith-based national health system made up of over 134,000 associates and 2,600 sites of care, including more than 140 hospitals and 40 senior living communities in 19 states.
Our Mission, Vision and Values encompass everything we do at Ascension. Every associate is empowered to give back, volunteer and make a positive impact in their community. Ascension careers are more than jobs; they are opportunities to enhance your life and the lives of the people around you.
**Equal Employment Opportunity Employer**
Ascension provides Equal Employment Opportunities (EEO) to all associates and applicants for employment without regard to race, color, religion, sex/gender, sexual orientation, gender identity or expression, pregnancy, childbirth, and related medical conditions, lactation, breastfeeding, national origin, citizenship, age, disability, genetic information, veteran status, marital status, all as defined by applicable law, and any other legally protected status or characteristic in accordance with applicable federal, state and local laws.
For further information, view the EEO Know Your Rights (English) ( poster or EEO Know Your Rights (Spanish) ( poster.
As a military friendly organization, Ascension promotes career flexibility and offers many benefits to help support the well-being of our military families, spouses, veterans and reservists. Our associates are empowered to apply their military experience and unique perspective to their civilian career with Ascension.
Pay Non-Discrimination Notice ( note that Ascension will make an offer of employment only to individuals who have applied for a position using our official application. Be on alert for possible fraudulent offers of employment. Ascension will not solicit money or banking information from applicants.
**E-Verify Statement**
This employer participates in the Electronic Employment Verification Program. Please click the E-Verify link below for more information.
E-Verify (

Req Number
ANA-

Location
Remote Within Continental US

Description

Travel Requirement

Less than 10 percent.

VA Background Investigation Requirement

• Candidate must hold or be eligible to undergo and pass a mandatory government background check.
• Candidate must pass a pre-employment drug screening.
• U.S. Citizenship may be required by certain federal customers.

Best Value Technology, Inc. (BVTI) is an established Service-Disabled Veteran-Owned Small Business (SDVOSB) with a 20-year track record delivering innovative data and technology solutions to the federal government.

BVTI is seeking an individual with strong experience in VBA Claims Processing to support an anticipated contract focused on delivering veteran benefits claims processing improvement efforts to programs within the Department of Veteran's Affairs. The candidate will provide subject matter expertise on VA disability compensation and/or pension claims processes, as well as VBA's documentation processes and workflows for these benefits. The candidate will also provide training and collaborate with Team Leaders supporting multiple project teams, providing direct support to the Department of Veterans Affairs, and contributing knowledge of VBA claims operations across various operational units. The ideal candidate will be a self-motivator who is attentive to details and possesses the training and problem-solving skills required to independently assess and advise a team, ensuring critical deadlines are met.

Position Requirements

Key Responsibilities

• Directly report to the Program Manager in the successful delivery of services across all assigned task areas including, but not limited to, claims processing, process improvement, and quality assurance.
• Participate in scheduled calls with customers, partners, and other VA stakeholders.
• Continually assess operations to ensure the quality of work complies with the contract performance requirements, foreseeing any need to initiate, recommend, approve, and/or provide solutions to prevent breakdowns in the benefits claims process.
• Continuously analyze claims-related processing and VBMS functionality changes and develop those changes into training resources for various teams.
• Collaborate with Team Leaders with Standard Operating Procedure and Job Aid development.
• Routinely provide guidance and performance feedback to Team Leaders.
• Monitor, gather, and analyze data related to work performance and success of process improvement efforts to share with the Program Manager.

Key Qualifications

• Experience supporting the Veteran's Benefits Administration (VBA).
• Familiarity with the Veterans Benefit Management System (VBMS).
• Experience with VBA's disability compensation and/or pension claims process as well as related documentation intake processes for these benefits.

Preferred Qualifications

• Experience with / understanding of common technologies and tools in use at the VA, such as Robotic Process Automation (RPA), Natural Language Processing (NLP), and similar technologies.
• Experience developing Standard Operating Procedures.
• Experience with project management and quality management frameworks such as PMBOK and Six Sigma.
• Veterans are strongly encouraged to apply.

Minimum Requirements

• Bachelor's degree in a related field. Additional certifications, education, and/or relevant training will be taken into consideration and weighed appropriately when extending an offer.
• 8-10 years of relevant experience.
• Extensive recent knowledge of VBA claims processing operations.
• Excellent oral and written communication skills.
• Proficient in using Microsoft Office applications (Word, Excel, and Outlook).
• Proficient in using MS Teams and Google Chat.

EOE Statement
Equal Employment Opportunity Employer

BVTI provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, or any other characteristic protected by federal, state or local laws.

This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Full-Time/Part-Time
Full-Time

Position
Senior Veterans Benefits Claims Analyst

Number of Openings
1

Exempt/Non-Exempt
Exempt

Open Date
8/28/2025

About the Organization
Talented people who make excellence their highest priority are BVTI's backbone. If your passion is to excel at adding value to your clients, then please send us your resume concerning one of our open opportunities.

This position is currently accepting applications.

Job DescriptionJob Description

The Copay Support Program Manager is a critical role within the organization and is primarily responsible for the creation, design, set-up and administration of Pharmacy and Medical Copay programs for AssistRx manufacturer clients. Required engagement with client, account managers, program managers, finance team members and other departments within the organization to implement and support all operational and financial processes related to claim processing activities. In addition, manager will ensure effective day-to-day operations and provide ongoing Copay program metrics for internal and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay utilization, establish escrow account minimum balances as well as replenishment needs. This position will identify and report Copay trends, patterns and behaviors as well as make recommendations to increase utilization based on Copay claims and patient compliance/adherence activities. Also, this position will implement data-driven initiatives to achieve operational and process excellence that will optimize and increase the number of Copay Programs supported and managed by AssistRx.

Key Responsibilities:

Program Strategy & Execution

• Serve as the primary client contact for the development, implementation, and ongoing management of pharmaceutical copay programs.
• Lead the design and administration of program business rules and ensure successful integration with adjudication systems.
• Oversee daily operations of assigned copay programs, ensuring service level excellence and compliance with contractual obligations.

Stakeholder Collaboration

• Partner cross-functionally with internal departments (Account Management, Program Management, Finance, IT) and external partners (vendors, adjudicators, pharmacies, sites of care) to ensure program success.
• Collaborate with clients on program enhancements, process improvements, and performance initiatives to maximize program utilization and outcomes.

Operational Excellence

• Direct the day-to-day activities of the copay team, including training, coaching, and mentoring team members on program operations and adjudication troubleshooting.
• Ensure effective quality control and accuracy in program set-up, updates, and reporting deliverables.
• Manage program performance through KPIs, metrics reporting, and operational reviews.

Data Analysis & Financial Oversight

• Analyze claims data to monitor copay program utilization, identify trends, and forecast program needs (escrow balances, replenishments).
• Provide actionable insights and recommendations to improve patient engagement and program adherence.
• Partner with finance to support billing processes, escrow account reconciliation, and financial reporting.

Client Engagement & Communication

• Build and maintain strong client relationships through proactive communication, trust-building, and delivering results.
• Present program metrics, performance trends, and recommendations during client meetings and business reviews.
• Act as a Subject Matter Expert on all matters related to copay and affordability programs within AssistRx.

Requirements

• Proven experience managing pharmacy or medical copay programs within a healthcare, pharma services, or HUB services environment.
• Strong understanding of claims adjudication processes, reimbursement models, and affordability solutions.
• Skilled in program design, implementation, and operational management.
• Advanced proficiency in data analysis and reporting with the ability to interpret and communicate business impacts.
• Excellent communication, client relationship management, and cross-functional collaboration skills.
• Leadership experience with a demonstrated ability to train, coach, and develop team members.
• Strong organizational skills with a focus on process improvement and operational excellence.

Experience:

• Experience working with adjudication platforms, HUB services, and pharmaceutical manufacturer programs.
• Familiarity with patient assistance programs, specialty pharmacy operations, and healthcare compliance standards.

Benefits

• Supportive, progressive, fast-paced environment
• Competitive pay structure
• Matching 401(k) with immediate vesting
• Medical, dental, vision, life, & short-term insurance

AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to , religion, , (including , , and ), parental status, , , , family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws.

All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check.

In compliance with federal law, all persons hired will be required to verify and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position.

AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no will be paid in the event of a hire.

The Copay Support Program Manager  is a critical role within the organization and is primarily responsible for the creation, design, set-up and administration of Pharmacy and Medical Copay programs for AssistRx manufacturer clients. Required engagement with client, account managers, program managers, finance team members and other departments within the organization to implement and support all operational and financial processes related to claim processing activities. In addition, manager will ensure effective day-to-day operations and provide ongoing Copay program metrics for internal and external business review meetings. Responsible for forecasts and analyzing claims data to determine Copay utilization, establish escrow account minimum balances as well as replenishment needs. This position will identify and report Copay trends, patterns and behaviors as well as make recommendations to increase utilization based on Copay claims and patient compliance/adherence activities. Also, this position will implement data-driven initiatives to achieve operational and process excellence that will optimize and increase the number of Copay Programs supported and managed by AssistRx. 

Key Responsibilities:

Program Strategy & Execution

• Serve as the primary client contact for the development, implementation, and ongoing management of pharmaceutical copay programs.
• Lead the design and administration of program business rules and ensure successful integration with adjudication systems.
• Oversee daily operations of assigned copay programs, ensuring service level excellence and compliance with contractual obligations.

Stakeholder Collaboration

• Partner cross-functionally with internal departments (Account Management, Program Management, Finance, IT) and external partners (vendors, adjudicators, pharmacies, sites of care) to ensure program success.
• Collaborate with clients on program enhancements, process improvements, and performance initiatives to maximize program utilization and outcomes.

Operational Excellence

• Direct the day-to-day activities of the copay team, including training, coaching, and mentoring team members on program operations and adjudication troubleshooting.
• Ensure effective quality control and accuracy in program set-up, updates, and reporting deliverables.
• Manage program performance through KPIs, metrics reporting, and operational reviews.

Data Analysis & Financial Oversight

• Analyze claims data to monitor copay program utilization, identify trends, and forecast program needs (escrow balances, replenishments).
• Provide actionable insights and recommendations to improve patient engagement and program adherence.
• Partner with finance to support billing processes, escrow account reconciliation, and financial reporting.

Client Engagement & Communication

• Build and maintain strong client relationships through proactive communication, trust-building, and delivering results.
• Present program metrics, performance trends, and recommendations during client meetings and business reviews.
• Act as a Subject Matter Expert on all matters related to copay and affordability programs within AssistRx.

Requirements

• Proven experience managing pharmacy or medical copay programs within a healthcare, pharma services, or HUB services environment.
• Strong understanding of claims adjudication processes, reimbursement models, and affordability solutions.
• Skilled in program design, implementation, and operational management.
• Advanced proficiency in data analysis and reporting with the ability to interpret and communicate business impacts.
• Excellent communication, client relationship management, and cross-functional collaboration skills.
• Leadership experience with a demonstrated ability to train, coach, and develop team members.
• Strong organizational skills with a focus on process improvement and operational excellence.

Preferred Experience:

• Experience working with adjudication platforms, HUB services, and pharmaceutical manufacturer programs.
• Familiarity with patient assistance programs, specialty pharmacy operations, and healthcare compliance standards.

Benefits

• Supportive, progressive, fast-paced environment
• Competitive pay structure
• Matching 401(k) with immediate vesting
• Medical, dental, vision, life, & short-term disability insurance

AssistRx, Inc. is proud to be an Equal Opportunity Employer. All qualified applicants will receive consideration without regard to race, religion, color, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, family medical history or genetic information, political affiliation, military service, or other non-merit based factors, or any other protected categories protected by federal, state, or local laws.

All offers of employment with AssistRx are conditional based on the successful completion of a pre-employment background check.

In compliance with federal law, all persons hired will be required to verify identity and eligibility to work in the United States and to complete the required employment eligibility verification document form upon hire. Sponsorship and/or work authorization is not available for this position.

AssistRx does not accept unsolicited resumes from search firms or any other vendor services. Any unsolicited resumes will be considered property of AssistRx and no fee will be paid in the event of a hire.

NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client and their team.
**$18/hour W2**
**Long Term Temporary**
**Start: approx. Sept. 9**
**6 week mandatory Video training**
**Hours: Mon - Fri - 7:30 - 4 CT.**
**In this Role the candidate will be responsible for:**
+ Processing of Professional claim forms files by provider
+ Reviewing the policies and benefits
+ Comply with company regulations regarding HIPAA, confidentiality, and PHI
+ Abide with the timelines to complete compliance training of NTT Data/Client
+ Work independently to research, review and act on the claims
+ Prioritize work and adjudicate claims as per turnaround time/SLAs
+ Ensure claims are adjudicated as per clients defined workflows, guidelines
+ Sustaining and meeting the client productivity/quality targets to avoid penalties
+ Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
+ Timely response and resolution of claims received via emails as priority work
+ Correctly calculate claims payable amount using applicable methodology/ fee schedule
**Requirements:**
+ 1-3 year(s) hands-on experience in Healthcare Claims Processing
+ 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
+ High school diploma or GED.
+ Previously performing - in P&Q work environment; work from queue; remotely
+ Key board skills and computer familiarity -
+ Toggling back and forth between screens/can you navigate multiple systems.
+ Working knowledge of MS office products - Outlook, MS Word and MS-Excel.
+ Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).
**Preferred Skills & Experiences:**
+ Amisys Preferred
+ Ability to communicate (oral/written) effectively in a professional office setting
+ Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
+ Time management with the ability to cope in a complex, changing environment
**About NTT DATA**
NTT DATA is a $0+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over 3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com ( .
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The pay rate for this remote role is 18 Hourly **.** This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.
NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client and their team.
**In this Role the candidate will be responsible for:**
+ Processing of Professional claim forms files by provider
+ Reviewing the policies and benefits
+ Comply with company regulations regarding HIPAA, confidentiality, and PHI
+ Abide with the timelines to complete compliance training of NTT Data/Client
+ Work independently to research, review and act on the claims
+ Prioritize work and adjudicate claims as per turnaround time/SLAs
+ Ensure claims are adjudicated as per clients defined workflows, guidelines
+ Sustaining and meeting the client productivity/quality targets to avoid penalties
+ Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
+ Timely response and resolution of claims received via emails as priority work
+ Correctly calculate claims payable amount using applicable methodology/ fee schedule
**Requirements:**
+ 1-3 year(s) hands-on experience in Healthcare Claims Processing
+ 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
+ High school diploma or GED.
+ Working knowledge of MS office products - Outlook, MS Word and MS-Excel and Teams
+ Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).
**Preferred Skills & Experiences:**
+ Amisys Preferred
+ Ability to communicate (oral/written) effectively in a professional office setting
+ Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
+ Time management with the ability to cope in a complex, changing environment
+ Previously performing - in P&Q work environment; work from queue; remotely
+ Key board skills and computer familiarity -
+ Toggling back and forth between screens/can you navigate multiple systems
**About NTT DATA**
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com ( .
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The pay rate for this remote role is 18 Hourly **.** This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.
For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
NTT DATA currently seeks a **Claims Processing Associate** to join our team for a remote position.
**Role Responsibilities**
-Processing of Professional claim forms files by provider
-Reviewing the policies and benefits
-Comply with company regulations regarding HIPAA, confidentiality, and PHI
-Abide with the timelines to complete compliance training of NTT Data/Client
-Work independently to research, review and act on the claims
-Prioritize work and adjudicate claims as per turnaround time/SLAs
-Ensure claims are adjudicated as per clients defined workflows, guidelines
-Sustaining and meeting the client productivity/quality targets to avoid penalties
-Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
-Timely response and resolution of claims received via emails as priority work
-Correctly calculate claims payable amount using applicable methodology/ fee schedule
**Required Skills/Experience**
+ 1+ years hands-on experience in Healthcare Claims Processing
+ 2+ years using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
+ High school diploma or GED.
+ Previously performing - in P&Q work environment; work from queue
+ Previous remote work experience
+ Key board skills and computer familiarity -
+ Toggling back and forth between screens/can you navigate multiple systems.
+ Working knowledge of MS office products - Outlook, MS Word and MS-Excel.
+ Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).
+ no time off during training and ramp up period
**Preferences**
-Amisys
-Ability to communicate (oral/written) effectively in a professional office setting
-Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
-Time management with the ability to cope in a complex, changing environment
About NTT DATA:
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com.
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is 18.00 hourly. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.
#LI-NorthAmerica

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.
NTT DATA is seeking to hire a **Remote Claims Processing Associate** to work for our end client and their team.
**In this Role the candidate will be responsible for:**
+ Processing of Professional claim forms files by provider
+ Reviewing the policies and benefits
+ Comply with company regulations regarding HIPAA, confidentiality, and PHI
+ Abide with the timelines to complete compliance training of NTT Data/Client
+ Work independently to research, review and act on the claims
+ Prioritize work and adjudicate claims as per turnaround time/SLAs
+ Ensure claims are adjudicated as per clients defined workflows, guidelines
+ Sustaining and meeting the client productivity/quality targets to avoid penalties
+ Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
+ Timely response and resolution of claims received via emails as priority work
+ Correctly calculate claims payable amount using applicable methodology/ fee schedule
**Requirements:**
+ 1-3 year(s) hands-on experience in Healthcare Claims Processing
+ 2+ year(s) using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
+ High school diploma or GED.
+ Previously performing - in P&Q work environment; work from queue; remotely
+ Key board skills and computer familiarity -
+ Toggling back and forth between screens/can you navigate multiple systems.
+ Working knowledge of MS office products - Outlook, MS Word and MS-Excel.
+ Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).
**Preferred Skills & Experiences:**
+ Amisys Preferred
+ Ability to communicate (oral/written) effectively in a professional office setting
+ Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
+ Time management with the ability to cope in a complex, changing environment
**About NTT DATA**
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com ( .
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The pay rate for this remote role is 18 Hourly **.** This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.

At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company's growth and market presence. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here.
For more than 25 years, NTT DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
NTT DATA currently seeks a **Claims Processing Associate** to join our team for a remote position.
**Role Responsibilities**
-Processing of Professional claim forms files by provider
-Reviewing the policies and benefits
-Comply with company regulations regarding HIPAA, confidentiality, and PHI
-Abide with the timelines to complete compliance training of NTT Data/Client
-Work independently to research, review and act on the claims
-Prioritize work and adjudicate claims as per turnaround time/SLAs
-Ensure claims are adjudicated as per clients defined workflows, guidelines
-Sustaining and meeting the client productivity/quality targets to avoid penalties
-Maintaining and sustaining quality scores above 98.5% PA and 99.75% FA.
-Timely response and resolution of claims received via emails as priority work
-Correctly calculate claims payable amount using applicable methodology/ fee schedule
**Required Skills/Experience**
+ 1+ years hands-on experience in Healthcare Claims Processing
+ 2+ years using a computer with Windows applications using a keyboard, navigating multiple screens and computer systems, and learning new software tools
+ High school diploma or GED.
+ Previously performing - in P&Q work environment; work from queue
+ Previous remote work experience
+ Key board skills and computer familiarity -
+ Toggling back and forth between screens/can you navigate multiple systems.
+ Working knowledge of MS office products - Outlook, MS Word and MS-Excel.
+ Must be able to work 7am - 4 pm CST online/remote (training is required on-camera).
+ no time off during training and ramp up period
**Preferences**
-Amisys
-Ability to communicate (oral/written) effectively in a professional office setting
-Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities
-Time management with the ability to cope in a complex, changing environment
About NTT DATA:
NTT DATA is a $30+ billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize, and transform for long-term success. We invest over $.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure, and connectivity. We are also one of the leading providers of digital and AI infrastructure in the world. NTT DATA is part of NTT Group and headquartered in Tokyo. Visit us at us.nttdata.com.
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is 18.00 hourly. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, flexible spending or health savings account, life, and AD&D insurance, short-and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits.
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