**In this Role the candidate will be responsible for:** + 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:** + 1-3 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. + Must be able to work 7am - 4 pm CST online/remote