This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description 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 Qualifications - 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 Requirements - 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

• Review and adjudicate medical claims, ensuring accurate coding, data entry, and application of appropriate reimbursement methodologies. • Verify patient eligibility, provider credentialing, and coverage details to facilitate accurate claims processing. • Communicate with internal resources, and internal stakeholders to resolve claim discrepancies, request additional information, or clarify issues. • Participate in ongoing training and professional development activities. • Maintain accurate and detailed records of claims processing activities. • Review claim forms and supporting documents • Determine eligibility, verify data accuracy • Request additional information when needed • Process claims end-to-end • Identify and escalate complex or unusual claims for further review or investigation.

Summary: The Life Claims & Annuity Sr. Specialist is responsible for assessing and making decisions on variable/portfolio death claims, death under income plan, variable/fixed annuity, and Northwestern Access Fund accounts. This role involves partnering with the contestable team on variable contestable claims. Ensuring compliance with a $2M signature authority limit involves analyzing various documents such as death certificates, claim forms, and legal documentation. Additionally, the specialist conducts routine reviews of claims by contract language and state laws. Primary Duties & Responsibilities: Decision Making and Claims Review - Make fair, accurate, and timely decisions on variable/portfolio death claims, death under Income plans, variable/fixed annuities, and Northwestern Mutual Access Fund accounts. Maintaining compliance with a $2M signature authority limit. - Examine claim information obtained, including beneficiary data, policy values, policy status, and analyze information received during the claim review process, such as death certificates, claim forms, assignment forms, divorce decrees, and estate and trust documentation. - Research and evaluate solutions to arising situations and resolve concerns as needed. Deviate from procedures to handle unique situations effectively. - Exhibit empathy, professionalism, and tact in all interactions, especially when handling sensitive or contentious claims. - Provide exceptional customer service to policyholders, beneficiaries, and financial advisers, addressing their questions and concerns throughout the claims process. - Communicate claims decisions to beneficiaries and other parties clearly and sensitively, providing detailed explanations and supporting documentation as needed. - Manage phone and transactional responsibilities while demonstrating a strong commitment to confidentiality. - Maintain organization, accuracy, and timeliness in individual case management systems; capture and document claim-related information accurately and/or refer tasks as appropriate. - Maintain production and claim quality standards to ensure efficiency and accuracy. Continuous Improvement and Innovation - Participate in continuous improvement initiatives to enhance claims handling processes, reduce turnaround times, and improve accuracy. - Assist with special projects and initiatives as needed to support the business. - Embrace new technology and serve as an advocate by educating beneficiaries and field representatives. - Support digital savvy capabilities in self and others and adapt to changing environments and new situations effectively and positively. Qualifications: - Bachelor’s degree or an equivalent combination of education and progressively responsible work experience. - A Series 6 FINRA License is required. - Previous experience in claims, income plan, or annuity preferred. - High degree of accuracy in handling detailed technical work. - Self-motivated with proven responsibility for work results and group goals. - Technically savvy with the ability to toggle between multiple applications and computer monitors simultaneously. - Strong organizational skills, able to independently prioritize to meet deadlines. - Exhibits empathy and strong client focus, with excellent customer service skills. - Excellent communication skills (both verbal and written) to include the proven ability to negotiate. - Leadership and decision-making skills, to include the abilities to evaluate/identify, diagnose, and implement decisions/solutions to questions/problems within the scope of the job. - Ability to analyze complex information and ask thoughtful questions. Desired Skills: - Adaptive Communication (Intermediate) - Attention to Detail (Advanced) - Customer Centricity (Intermediate) - Decision Making (Intermediate) - Analytical Thinking (Advanced) - Empathetic Communication (Intermediate) - Prioritization (Intermediate) - Claims Acumen (Intermediate) - Annuity Product Knowledge (Intermediate) This position has been classified as a Registered Representative under NMIS guidelines and requires fingerprinting.Series 6 - FINRA, SIE - FINRA Compensation Range: Pay Range - Start: $57,260.00 Pay Range - End: $106,340.00 Geographic Specific Pay Structure: Structure 110: $63,000.00 USD - $117,000.00 USD Structure 115: $65,870.00 USD - $122,330.00 USD We believe in fairness and transparency. It’s why we share the salary range for most of our roles. However, final salaries are based on a number of factors, including the skills and experience of the candidate; the current market; location of the candidate; and other factors uncovered in the hiring process. The standard pay structure is listed but if you’re living in California, New York City or other eligible location, geographic specific pay structures, compensation and benefits could be applicable, click here to learn more. Grow your career with a best-in-class company that puts our clients' interests at the center of all we do. Get started now! Northwestern Mutual is an equal opportunity employer who welcomes and encourages diversity in the workforce. We are committed to creating and maintaining an environment in which each employee can contribute creative ideas, seek challenges, assume leadership and continue to focus on meeting and exceeding business and personal objectives.

• Prepare, submit, and track insurance claims for Applied Behavior Analysis (ABA) services. • Review claims for accuracy and completeness prior to submission. • Follow up on outstanding, rejected, or denied claims with insurance providers. • Investigate and resolve claim discrepancies, denials, and payment issues. • Work closely with billing, scheduling, and clinical teams to ensure services are billed correctly. • Verify client insurance information and ensure authorizations align with billed services. • Maintain accurate records of claims, payments, and correspondence with payers. • Ensure compliance with payer requirements, company policies, and healthcare billing regulations. • Provide regular updates and reports on claim status and reimbursement trends.