Xcelys Medical Claims Examiner

3 weeks ago

Toronto Montreal Calgary Vancouver Edmonton Old Toronto Ottawa Mississauga Quebec Winnipeg Halifax Saskatoon Burnaby Hamilton Victoria Surrey Halton Hills London Regina Markham Brampton Vaughan Kelowna Laval Southwestern Ontario R, Canada NTT DATA North America Full time

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.NTT DATA Services currently seeks Xcelys Medical Claims Examiners to join our team remotely for a 3 month contract role.MUST HAVE XCELYS EXPERIENCERole Responsibilities:Adjudication & ReviewProcess comprehensive medical claims using Xcelys and associated subsystemsResolve complex pends, coding issues, and contract exceptionsAuthor overpayment/underpayment determinations and coordinate appealsQuality & ComplianceEngage in quality reviews, audits, root cause analysesMonitor accuracy, variance, and rework metricsEnsure alignment with regulatory and internal compliance guidelinesSupportAct as escalation point and subject matter expertProcess & System ImprovementParticipate in system testing, UAT, and workflow enhancementsRecommend improvements, document system and process changesReporting & AnalyticsPrepare production, pending, and quality reportsIdentify trends and recommend corrective actionsCross-Functional CollaborationLiaise with provider relations, legal, IT, compliance teamsSupport internal initiatives related to claims systems / operational improvementsRequired Skills/Experience5+ years claims adjudication experienceMinimum of 1 year experience in Xcelys2+ years in coding (CPT, ICD-10, HCPCS)2+ years provider contracts, pricing, regulatory guidelines experiencePreferencesExcellent analytical and communication skillsExperience training staff or acting as a mentorFamiliarity with system testing and documentationAbility to manage high-volume workload and meet performance metricsHours: Must be able to work 8am-5pm PSTEducation: Verifiable high school diploma or GEDNTT DATA Services is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law.The starting hourly range for this remote role is ($20 - $21/hourly ).This position is eligible for company benefits that will depend on the nature of the role offered. #J-18808-Ljbffr

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