Job description
NTT DATA Services 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 TEMP BPO Senior Representative to join our team in Plano, Texas (US-TX), United States (US).
In these roles you will be responsible for:
Required Skills for this role include:
Preferred Skills for this role include:
*** All new hires will be required to successfully complete our training classes and demonstrate proficiency of the material ***
About NTT DATA Services
NTT DATA Services is a global business and IT services provider specializing in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. We are part of the NTT family of companies, a partner to 85 % of the Fortune 100.
NTT DATA Services 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.
We are currently seeking a TEMP BPO Senior Representative to join our team in Plano, Texas (US-TX), United States (US).
In these roles you will be responsible for:
- Analyzing and processing claims transactions in accordance with plan provisions
- Adjudicating claims based on your knowledge of covered benefits, insurance and provider contracts
- Determining plan liability as well as diversion and recovery activity for claims
- Ensuring customer satisfaction and strive to meet service standards
- Collaborating with management or other team members as appropriate to proactively address service issues and concerns.
- Check if the services provided on the claim are as per members' benefit plan and/or if the necessary authorization, referrals, and pre-registration were obtained as required by the plan.
- Working with staff to resolve questions.
- Working with team lead and audit team on audit findings
- Manually calculate and/or apply pricing to each claim when necessary.
- Meet individual quality and production standards as needed.
- Contribute to team and departmental quality and production standards.
Required Skills for this role include:
- 3+ year(s) of customer service/medical claims processing experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product.
- 3+ year(s) experience processing complex claims including coordination of benefits and manually pricing services
- 3+ years(s) of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools.
- 3+ years of experience where you had to follow outlined processes to make appropriate decisions
- 2+ years of experience that required prioritizing your workload to meet deadlines
- An education level of at least a high school diploma or GED
- Communicating effectively and professionally with both internal and external customers to resolve questions and issues.
- Collaborating with management or other team members as appropriate to proactively address service issues and concerns.
Preferred Skills for this role include:
- 2+ year(s) experience inapplications, such as Diamond, Macess, and HealthEdge preferred. Understanding of managed care concepts and a strong understanding of CPT, ICD-10), HCPCS coding guidelines and CMS1500 & UB04 billing forms preferred
*** All new hires will be required to successfully complete our training classes and demonstrate proficiency of the material ***
About NTT DATA Services
NTT DATA Services is a global business and IT services provider specializing in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services. We are part of the NTT family of companies, a partner to 85 % of the Fortune 100.
NTT DATA Services 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.
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