Req ID: 361179 NTT DATA strives to hire exceptional, innovative and passionate individuals who want to grow with us. If you want to be part of an inclusive, adaptable, and forward-thinking organization, apply now. We are currently seeking a Medical Claims Processor to join our team in Plano, Texas (US-TX), United States (US). NTT DATA is seeking to hire a Remote Claims Processing Associate to work for our end client and their team. 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: • 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 – o Toggling back and forth between screens/can you navigate multiple systems. o Working knowledge of MS office products – Outlook, MS Word and MS-Excel. Preferred Skills & Experiences: • Amisys • Ability to communicate (oral/written) effectively in a professional office setting • Effective troubleshooting where you can leverage your research, analysis and problem-solving abilities • Time management with the ability to cope in a complex, changing environment About NTT DATA NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. our consulting and Industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D. Whenever possible, we hire locally to NTT DATA offices or client sites. This ensures we can provide timely and effective support tailored to each client’s needs. While many positions offer remote or hybrid work options, these arrangements are subject to change based on client requirements. For employees near an NTT DATA office or client site, in-office attendance may be required for meetings or events, depending on business needs. At NTT DATA, we are committed to staying flexible and meeting the evolving needs of both our clients and employees. NTT DATA recruiters will never ask for payment or banking information and will only use @nttdata.com and @talent.nttdataservices.com email addresses. If you are requested to provide payment or disclose banking information, please submit a contact us form, https://us.nttdata.com/en/contact-us. NTT DATA endeavors to make https://us.nttdata.com 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. If you'd like more information on your EEO rights under the law, please click here. For Pay Transparency information, please click here.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description If you’re passionate about helping people restore their lives when the unexpected happens to their homes and providing the best customer experience, then our Mercury Insurance Property Claims team could be the place for you! Upon completion of the training program, ideal candidates will transition into a property claims field adjusting position traveling to loss sites that have been damaged by fire, water, weather, or other unexpected events. You may also handle some claims via virtual technology and/or collaborate with vendors. The Property Claims Field Adjuster II will learn to apply knowledge of current Company policies, applicable regulatory standards, and procedures to investigate, evaluate, and settle moderate Homeowner's property claims in a timely and efficient manner as to prevent unnecessary expense to the Company and policyholders, and provide exceptional service to our customers. Responsibilities - Investigate and resolve Homeowners claims of moderate complexity in a timely and efficient manner. - Document with photographs, measurements, recorded interviews as needed, write a repair estimate to capture damages, and complete thorough file notes. - Perform field inspections at least 50% of work time (company car provided). - Handle virtual claims using imagery and advanced video technology to collaborate with onsite vendors and insureds. - Compare facts gathered during the investigation against the policy to determine coverage of claim; extend or deny coverage as appropriate. - Establish reserve amounts within prescribed settlement authority limit and negotiate settlement of claims. - Communicate effectively and timely with insureds and/or their representatives to resolve issues and ensure customer satisfaction. - Prioritize responsibilities and manage claims workload to monitor progress and expenses. - Direct, monitor, and review files handled by independent adjusters to conclusion. - Other functions may be assigned. Qualifications - Bachelor’s degree preferred or equivalent combination of education and experience. - Valid driver’s license is required. - Ability to obtain state specific property claims licensing, as required. - Must successfully participate and complete formal property claims training program. - Prior experience using estimating software like Xactimate. - Experience in a related field: property claims experience, customer service environment, construction, restoration, mitigation. - Known for clear and professional communication, both written and verbal. - Bilingual and/or prior military experience is a plus. - 3-5+ years equivalent industry experience is preferred. Knowledge and Skills - Ability to work independently with limited or no supervision. - Passion for outstanding customer service. - Ability to make quality decisions based on analysis, wisdom, experience, and judgment. - Comfortable with and adaptable to new technology and business tools. - Ability to seamlessly transition between various methods of inspection. - Ability to lift and carry up to 50 pounds. - Strong organizational, time management, and prioritization skills. - Willingness to work flexible shifts and overtime as needed. - Drive to and from multiple locations and occasionally outside of normal business hours. Benefits - Competitive compensation. - Flexibility to work from anywhere in the United States for most positions. - Paid time off (vacation time, sick time, 9 paid Company holidays, volunteer hours). - Incentive bonus programs (potential for holiday bonus, referral bonus, and performance-based bonus). - Medical, dental, vision, life, and pet insurance. - 401 (k) retirement savings plan with company match. - Engaging work environment. - Promotional opportunities. - Education assistance. - Professional and personal development opportunities. - Company recognition program. - Health and wellbeing resources, including free mental wellbeing therapy/coaching sessions.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description We are looking for an experienced Workers’ Compensation Claim Specialist to join our remote team supporting multiple California jurisdiction PEO accounts. In this role, you’ll be trusted to manage your files independently while contributing to a larger team focused on service excellence, compliance, and client partnership. This position offers the stability of dedicated clients, manageable caseloads, and regular collaboration with a team of seasoned WC professionals. A one-week, in-person onboarding and connection session at our Scottsdale office is available to help you integrate seamlessly into the team. Please note: This is not an HR, administrative, consulting, or advisory support role. This is a true adjusting position. Candidates must have proven experience conducting full investigation, evaluation, negotiation, and resolution of workers’ compensation claims, with end-to-end file ownership and decision-making authority. Applicants without direct claims adjusting experience will not be considered. - Investigate, evaluate, and adjust California workers’ compensation claims in compliance with state regulations, CCMSI handling standards, and client instructions. - Establish and maintain accurate reserves and thorough documentation within assigned authority levels. - Review, authorize, and process medical, legal, and indemnity payments. - Negotiate claim settlements aligned with jurisdictional guidelines and industry best practices. - Maintain consistent, professional communication with clients, claimants, attorneys, and providers. - Participate in claim reviews, quality audits, and team discussions to support consistency and compliance. - Deliver excellent client service through timely, detailed, and thoughtful claim handling. Qualifications - Minimum of 10 years of workers’ compensation claim adjusting experience. - Proficiency in Microsoft Office (Word, Excel, Outlook). - Strong written and verbal communication skills. - Proven ability to manage deadlines and multiple priorities effectively. - California jurisdiction experience required. Requirements - California SIP certification (preferred). - Claim review presentation experience (preferred). - AIC, ARM, or CPCU designation (preferred). Benefits - 4 weeks PTO + 10 paid holidays in your first year. - Comprehensive benefits: Medical, Dental, Vision, Life, and Disability Insurance. - Retirement plans: 401(k) and Employee Stock Ownership Plan (ESOP). - Career growth: Internal training and advancement opportunities. - Culture: A supportive, team-based work environment.

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description The Claims Assistant will support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific customer needs. This role is available for both remote and hybrid work arrangements. Essential Functions & Responsibilities: - Sets up new claims - Process mail, handle files (until paperless), and input notes/diary entries in the claims system - Process payments, as needed - Process form letters, state forms and reports - Assist claims examiners with telephone calls including provider, claimant and customer calls - Additional duties as assigned Qualifications - Excellent written and verbal communication skills - PC literate, including Microsoft Office (Word, Excel) - Ability to work independently and in a team environment - Strong organizational skills Requirements - High school diploma, college degree preferred - Six (6) months of service oriented office experience preferred Benefits - Comprehensive benefits package for full-time regular employees - Medical (HDHP) w/Pharmacy - Dental - Vision - Long Term Disability - Health Savings Account - Flexible Spending Account Options - Life Insurance - Accident Insurance - Critical Illness Insurance - Pre-paid Legal Insurance - Parking and Transit FSA accounts - 401K and ROTH 401K - Paid time off Company Description CorVel, a certified Great Place to Work® Company, is a national provider of industry-leading risk management solutions for the workers’ compensation, auto, health and disability management industries. CorVel was founded in 1987 and has been publicly traded on the NASDAQ stock exchange since 1991. Our continual investment in human capital and technology enable us to deliver the most innovative and integrated solutions to our clients. We are a stable and growing company with a strong, supportive culture and plenty of career advancement opportunities. Over 4,000 people working across the United States embrace our core values of Accountability, Commitment, Excellence, Integrity and Teamwork (ACE-IT!).