Temp Bpo Senior Representative

Processing of Professional and Hospital claim form 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 and guidelines. Sustaining and meeting the client productivity/ quality targets to avoid penalties. Maintaining and sustaining quality scores above 9.5% PA and 99.75% FA. Timely response and resolution of claims received via email as priority work. Correctly calculate claims payable amount using applicable methodology/ fee schedule.