Appleton, Wisconsin
Claims Analyst Job Opening in Appleton, Wisconsin - At NTT DATA Services, 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 Services and for the people who work here.
Claims Analyst
Reports To: Supervisor ? Claims
SUMMARY
The purpose of the Claims Analyst is to provide exceptional customer service. Claims Analysts process medical, dental, disability, pharmacy, and flexible spending claims in a timely and accurate manner. Claims Analysts are the primary contact for our groups and members in answering claims questions and resolving issues. The analyst is also responsible for performing check runs for their groups.
ESSENTIAL DUTIES AND RESPONSIBILITIES
Report to work during core business hours (8:00 a.m. ? 5:00 p.m.) on a consistent, regular basis
Process medical and/or dental claims, as well as disability, pharmacy, flexible spending, or vision claims, if applicable
Interpret and apply specific plan document language as well as determine eligibility for benefits during claims adjudication
Provide written correspondence and verbal information to members, group contacts, agents, and healthcare providers.
Refer potential abuse, subrogation, and adjustment claims
Perform necessary check run process and communicate check register information
Provide responsive and professional customer service for assigned groups as well as other groups with Client as needed.
Maintain a positive and professional attitude.
Work with members of staff on identifying process improvements
Flexibility to work overtime as dictated by department/company needs.
Perform other duties as assigned by management.
EXPERIENCE
Thorough understanding of Self-Funding and Third Party Administrating concepts. Demonstrated written and oral communication skills required. Ability to navigate through and utilize various PC applications efficiently. Strong organizational skills, problem solving and decision making skills required. Self-direction and self-starter skills required. Strong understanding of claims analyst process and procedures skills. Must have coding and medical terminology training.
Must be able to work core business hours of 8:00 -5:00.
1-2 years previous experience required.
High School Diploma or Equivalent required.
About NTT DATA
NTT DATA, Inc., together with its subsidiaries, is a leading business and IT services provider and global innovation partner, and part of the NTT DATA family of companies, with 80,000 professionals based in over 40 countries. NTT DATA combines global reach and local intimacy to provide premier professional services, including consulting, application services, business process and IT outsourcing, and cloud-based solutions. NTT DATA is part of NTT Group, one of the world?s largest technology services companies, generating more than $100 billion in annual revenues, and partner to 80% of the Fortune Global 100. Visit /americas to learn how our consultants, projects, managed services, and outsourcing engagements deliver value for a range of businesses and government agencies.
NTT DATA, Inc. (the ?Company?) is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex, sexual orientation, genetic information, physical or mental disability, veteran or marital status, or any other class protected by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.
Job Type: Full-time
Required education:
High school or equivalent
Required experience:
customer service: 1 year
Medical Terminology: 1 year
employee benefits or self-funded insurance: 2 years
claims processing: 2 years
|
