Claims Associate

NTT Data Corporation Rochester , NY 14618

Posted 8 months ago

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 Services and for the people who work here.

Req ID: 46426

Review, annotate, and accurately enter claims for participants according to state and federal regulations and the Company and departmental policies and procedures. Create denial letters for claims that are ineligible and\or are incomplete; mail denials to participants.

  • Review claims for accuracy, ensuring all form fields are filled out completely and the form is signed; determine eligibility of each claim per appropriate Section 105, Section 125 and Section 132 regulations.

  • Annotate claim form per departmental procedures, including initialing the form, stamping it with the date and identifying each line of claim form with the proper transaction code and\or denial code.

  • Accurately enter all claim data into claims entry program including, but not limited to, transaction code, service dates, received date, requested amount, denial code and amount, address changes. Ensure that all claims are entered no later than five business days after claim received date.

  • Create denial letters for claims that cannot be reimbursed because they are incomplete and\or are ineligible per IRS Section 105, 125 and 132 regulations. Ensure that denial letters are created no later than five business days after claim received date and mailed to participants the following business day.

  • If assigned debit card follow-up, accurately enter debit card substantiation follow-up and unsuspended cards in the debit card administration software. Enter cardholder repayments and offset claims into administrative software. Ensure that this process is completed no later than five business days after follow-up received date.

  • Prepare and distribute accurate administrative paperwork including, but not limited to, claim forms, debit card follow-up, green sheets, as needed and in accordance with company policies and procedures.

  • Perform a variety of miscellaneous administrative and job-related duties as requested to support operations and or achieve business goals and objectives including, but not limited to, photocopying, mailing, filing, and ensuring timely responses to a variety of routine inquiries.

  • Maintain knowledge of current state and federal laws and regulations affecting employee benefit claim administration including, but not limited to, Section 105, Section 125 and Section 132, ERISA, HIPAA, FMLA, HSA and COBRA regulations.

NTT DATA, Inc. (the "Company") is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex sexual orientation genetic information, physical or mental disability, veteran or marital status, or any other class protested by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.

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Claims Associate

NTT Data Corporation