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At NTT DATA, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees have been key factors in our company’s growth and market presence. 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.

For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.

NTT DATA Services currently seeks a **Medical Claims Processors** to join our team in **remotely.**

Role Responsibilities

To serve as a **Medical Claims Processor within the Xcelys environment** , you **must have a minimum of 3 yr hands-on, working experience within its environment** . You should also provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations.

Role Responsibilities:

Adjudication & Review

+ Process comprehensive medical claims using Xcelys and associated subsystems

+ Resolve complex pends, coding issues, and contract exceptions

+ Author overpayment/underpayment determinations and coordinate appeals

Quality & Compliance

+ Engage in quality reviews, audits, root cause analyses

+ Monitor accuracy, variance, and rework metrics

+ Ensure alignment with regulatory and internal compliance guidelines

Support

+ Act as escalation point and subject matter expert

Process & System Improvement

+ Participate in system testing, UAT, and workflow enhancements

+ Recommend improvements, document system and process changes

Reporting & Analytics

+ Prepare production, pending, and quality reports

+ Identify trends and recommend corrective actions

Cross-Functional Collaboration

+ Liaise with provider relations, legal, IT, compliance teams

+ Support internal initiatives related to claims systems / operational improvements

Required Skills/Experience

+ 5+ years claims adjudication experience

+ Minimum of 1 year experience in Xcelys

+ 2+ years in coding (CPT, ICD-10, HCPCS)

+ 2+ years provider contracts, pricing, regulatory guidelines experience

+ Verifiable high school diploma or GED

+ Must be able to work 8am-5pm PST

About NTT DATA

NTT DATA is a $30 billion trusted global innovator of business and technology services. We serve 75% of the Fortune Global 100 and are committed to helping clients innovate, optimize and transform for long-term success. As a Global Top Employer, we have diverse experts in more than 50 countries and a robust partner ecosystem of established and start-up companies. Our services include business and technology consulting, data and artificial intelligence, industry solutions, as well as the development, implementation and management of applications, infrastructure and connectivity. We are one of the leading providers of digital and AI infrastructure in the world. NTT DATA is a part of NTT Group, which invests over $3.6 billion each year in R&D to help organizations and society move confidently and sustainably into the digital future. Visit us at us.nttdata.com (http://us.nttdata.com/en)

NTT DATA endeavors to make https://us.nttdata.com (https://us.nttdata.com/en) accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact us at https://us.nttdata.com/en/contact-us . This contact information is for accommodation requests only and cannot be used to inquire about the status of applications. NTT DATA is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. For our EEO Policy Statement, please click here (https://us.nttdata.com/en/compliance#eeos) . If you'd like more information on your EEO rights under the law, please click here (https://us.nttdata.com/en/compliance#know-your-rights) . For Pay Transparency information, please click here (https://us.nttdata.com/en/compliance#ppnp) .