Claims Examiner

NTT DATA Careers

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Plano, Texas, US Until 8/22/2026 H-1B sponsor history First posted July 28, 2025 Last posted July 28, 2025
Job description
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
About this role

Summary

Process claims, review policies, ensure compliance, and meet quality targets.

Job title

Claims Examiner

Experience level

1-3 years

Industry

healthcare

Location requirements

Located in Plano, Texas; remote work allowed

Salary

Not specified

Visa sponsorship

H-1B sponsor history

Management role

No

Skills & keywords

Required skills

healthcare claims processingcomputer skillshigh school diplomaMS officeremote work

Preferred skills

None specified

Specializations

claims processingHIPAAquality assuranceMS officeremote work
Locations

Structured locations inferred from the posting.

Texas, USA

Remote State

Plano, TX, USA

On-site City