Medical Claims Examiner Remote
Sierra Systems, an NTT DATA Company · Wichita, KS
Job description
HC & Insurance Operations Processing Sr Rep NTT Data Services is Hiring! Grade 3 - HC & Insurance Operations Sr Rep Position's Overview At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factorsin our company's growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring, the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA and for the people who work here. NTT DATA, Inc. currently seeks an "BPO HC & Insurance Operations Sr Rep" to join our team in "Coimbatore". Client's business problem to solve? Our Client is one of Leading Health Plan in US providing services in Florida state, NTT are getting into contract with Client to manage End to End Claims Administration services. Our NTT Business Process Outsourcing (BPO) team has implemented the processes and technologies for our clients bring about real transformation for customers of all sizes. Our end-to-end administrative services help streamline operations, improve productivity and strengthen cash flow to help our customers stay competitive and improve member satisfaction Position's General Duties and Tasks In these roles you will be responsible for: • Review and process insurance claims. • Validate Member, Provider and other Claim's information. • Determine accurate payment criteria for clearing pending claims based on defined Policy and Procedure. • Coordination of Claim Benefits based on the Policy & Procedure. • Maintain productivity goals, quality standards and aging timeframes. • Scrutinizing Medical Claim Documents and settlements. • Organizing and completing tasks per assigned priorities. • Developing and maintaining a solid working knowledge of the healthcare insurance industry and of all products, services and processes performed by the team Resolving complex situations following pre-established guidelines Requirements for this role include: • University degree or equivalent that required formal studies of the English language and basic Math • 6+ months of experience where you had to apply business rules to varying fact situations and make appropriate decisions • 6+ months of data entry experience that required a focus on quality including attention to detail, accuracy, and accountability for your work product. • 6+ months of experience using a computer with Windows PC applications that required you to use a keyboard, navigate screens, and learn new software tools. Required schedule availability for this position is Monday-Friday (06:00pm to 04:00am IST). The shift timings can be changed as per client requirements. Additionally, resources may have to do overtime and work on weekend's basis business requirement.
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Ascension · Wichita, KS
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" " Licensed Psychiatric Nurse Practitioner Wage: Up to $176.17/hour Did you know that you can build a flexible private practice on your terms as a psychiatric nurse practitioner? Whether you want to see patients alongside a full-time job or grow a full-time practice, Headway makes it easy to accept insurance, boost your earnings, and focus on care - without the administrative burden. It's all on one free-to-use platform, no commitment required. About the role This position is for licensed psychiatric nurse practitioners looking to start or grow their private practice. Headway provides the tools, resources, and support to help you navigate insurance, streamline operations, and let you focus on what matters most - your patients. About you • You're a fully licensed psychiatric nurse practitioner with your DEA or CDS number, ANCC or AANP board certification, a valid NPI number and malpractice insurance. • You're looking to start or expand your private practice while maintaining control over your schedule, client load, and work environment. Why partner with Headway? As an independent provider with Headway, you'll gain access to: • Hassle-free insurance credentialing: Get credentialed for free in multiple states within as little as 30 days. • Increased earnings: Secure competitive rates with top insurance plans through our nationwide network. • Predictable bi-weekly payments: Receive reliable payouts directly from Headway. • Built-in EHR tools: Access real-time scheduling, secure client messaging, documentation templates, assessments, and more. • Compliance & audit support: Stay up-to-date with insurance requirements and industry regulations. • Free continuing education: Earn CEUs and expand your expertise through Headway Academy. How Headway supports your patients • Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. • Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Important Notes • This is a 1099 independent contractor role. You'll have full autonomy over your practice, including setting your hours and managing your caseload. • At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license. About Headway We make it easy for mental health providers to take insurance by credentialing you with the nation's largest networks, handling billing and admin paperwork, and helping you earn more stable income with higher rates. With Headway, you can finally focus on what matters most: providing life-changing care. We'll take care of the rest.