Medical Claims Examiner Remote (Plano, TX, US)

Req ID: 374733 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Medical Claims Examiner Remote to join our team in Plano, Texas (US-TX), United States (US). In these roles you will be responsible for: Review and process insurance claims. • Validate Member, Provider and other Claim’s information. • Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure. • Coordination of Claim Benefits based on the Policy & Procedure. • Maintain productivity goals, quality standards and aging timeframes. • Scrutinizing Medical Claim Documents and settlements. • Organizing and completing tasks per assigned priorities. • Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team • Resolving complex situations following pre-established guidelines Requirements for this role include: University degree or equivalent that required formal studies of the English language and basic Math • 6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions • 6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product. • 6+ months of experience us