[Hiring] Medical Claims Processor REMOTE USA
Position: Medical Claims Processor – Remote
Date Posted: September 19, 2026
Industry: Healthcare / Insurance Claims Processing
Employment Type: Full Time
Experience: 1–3 years of hands-on experience in Healthcare Claims Processing
Qualification: High School Diploma or GED
Salary: $18 per hour
Location: REMOTE, United States
Company: NTT DATA North America
Description:
NTT DATA North America is seeking a Remote Claims Processing Associate to support healthcare claims operations for its client. This role is suitable for professionals with experience in medical claims processing who can independently review, analyze, and process healthcare claims while maintaining accuracy and compliance standards.
The successful candidate will review provider-submitted professional claim forms, verify policies and benefits, process claims according to established guidelines, and ensure compliance with healthcare regulations. The role requires strong attention to detail, computer skills, and the ability to work efficiently in a remote environment.
Key Responsibilities:
• Process professional healthcare claim forms submitted by providers.
• Review insurance policies, benefits, and applicable claim guidelines.
• Research, analyze, and take appropriate action on assigned claims.
• Adjudicate claims according to client workflows, procedures, and service-level agreements.
• Calculate payable claim amounts using applicable methodologies and fee schedules.
• Maintain productivity and quality standards while meeting client targets.
• Ensure compliance with HIPAA, confidentiality requirements, and protected health information (PHI) guidelines.
• Respond to priority claims received through email and resolve issues promptly.
• Maintain accurate records and documentation throughout the claims process.
Requirements:
• 1–3 years of experience in healthcare claims processing.
• High School Diploma or GED.
• Experience working with Windows applications, multiple screens, and computer systems.
• Ability to work remotely in a queue-based claims processing environment.
• Strong keyboard skills and computer proficiency.
• Knowledge of Microsoft Office applications, including Outlook, Word, and Excel.
• Ability to work independently while managing deadlines and productivity goals.
• Strong communication, troubleshooting, research, and problem-solving skills.
• Availability to work 7:00 AM – 4:00 PM CST with required online training.
• Strong knowledge of:
• Healthcare claims processing and adjudication procedures.
• Insurance policies, benefits review, and claim workflows.
• Microsoft Office tools and computer-based applications.
• Data accuracy, quality control, and healthcare compliance requirements.
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