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Senior Claims Processing Associate

United States, Plano · Job Posted March 22, 2026
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Job Description

The Senior Claims Processing Associate role at NTT DATA involves processing healthcare claims, ensuring compliance with HIPAA regulations, and maintaining high-quality standards.

Job Responsibility

  • 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

  • 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.

Nice to have

  • 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

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