Job Closed
This listing is no longer active.
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.
HC & Insurance Operations Processing Sr Rep
Location
United States
Posted
63 days ago
Salary
0
Seniority
Senior
No structured requirement data.
Job Description
HC & Insurance Operations Processing Sr Rep
NTT DATA
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
Related Guides
Related Categories
Related Job Pages
More Operations Jobs
Senior SRO Operations Training Lead
Switzerland Global EnterpriseWe support Swiss SMEs in their international business and help innovative foreign companies to establish in Switzerland.
• Serves as a lead technical and program resource for the design, development, delivery, and continuous improvement of licensed and non-licensed operations training programs for BWRX-300 technologies • Provides functional leadership across assigned programs, applies the Systematic Approach to Training (SAT) • Ensures training products and delivery meet business, customer, and regulatory expectations • Acts as a key interface with internal stakeholders, customers, and regulatory organizations
OPERATIONS TECHNICIAN II - PUBLIC SECTOR
Lumen TechnologiesLumen Technologies is self-described as a global company of 40,000+ professionals empowering businesses, government, and communities to “produce amazing things.” Driven by the
Lumen is the trusted network for AI. We’re transforming how businesses connect, secure, and scale in an AI-driven world. By connecting people, data, and applications quickly, securely, and effortlessly, we help organizations move faster and unlock what’s next. At Lumen, people power progress. Our culture is built on teamwork, trust, and transparency, giving you the flexibility, support, and opportunity to make a lasting impact. We’re looking for top-tier talent ready to take on the challenge. Join us in building the future. The Role The Operations Technician will work in a fast-paced, 24/7/365 environment supporting Lumen SLED (State, Local, Educational) customers. Each customer has unique requirements and support processes. The Main Responsibilities - Support 24/7/365 operations for 22 individual customers. - Monitor network devices using multiple platforms, including SolarWinds and the Meraki Dashboard. - Provide and maintain support services for internal teams in support of customer needs. - Create and maintain trouble tickets for break/fix incidents, customer requests, and escalations. - Perform basic configuration changes on supported devices. - Respond to team communications in a timely and professional manner. What We Look For in a Candidate Basic Qualifications: • Ability to obtain and maintain Public Trust suitability for the duration of employment with Lumen. • Ability to communicate clearly with customers, Lumen support teams, and team members. • Comfortable communicating professionally via phone, email, and Microsoft Teams. • Willingness to work a shift-based schedule to support 24/7 coverage, including weekends and holidays. This role is scheduled for Sunday–Thursday, 3:00 p.m. ET to 11:30 p.m. ET. Preferred Qualifications: • Associate degree in a related field, or equivalent experience in a high-paced NOC (Network Operations Center) environment. • Foundational understanding of networking technologies aligned with entry-level Cisco and Juniper certifications. • Familiarity with tools and technologies such as Cisco, Meraki, SDWAN, circuit testing, SolarWinds, and WebHelpDesk (or similar ticketing systems), as well as new technologies introduced to meet customer needs. • Ability to work consultatively with others (e.g., establish rapport, ask effective questions, gather facts, present options, recommend solutions, follow up, and maintain a customer-focused approach). • Demonstrated ability to work effectively in a dynamic team environment with changing requirements and competing priorities. Compensation This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Individual pay is based on skills, experience and other relevant factors. Location Based Pay Ranges $56,900 - $76,000 in these states: AL AR AZ FL GA IA ID IN KS KY LA ME MO MS MT ND NE NM OH OK PA SC SD TN UT VT WI WV WY $59,850 - $79,800 in these states: CO HI MI MN NC NH NV OR RI $62,700 - $83,600 in these states: AK CA CT DC DE IL MA MD NJ NY TX VA WA Lumen offers a comprehensive package featuring a broad range of Health, Life, Voluntary Lifestyle benefits and other perks that enhance your physical, mental, emotional and financial wellbeing. We're able to answer any additional questions you may have about our bonus structure (short-term incentives, long-term incentives and/or sales compensation) as you move through the selection process. Learn more about Lumen's:BenefitsBonus Structure #LI-Remote Requisition #: 341640 Background Screening If you are selected for a position, there will be a background screen, which may include checks for criminal records and/or motor vehicle reports and/or drug screening, depending on the position requirements. For more information on these checks, please refer to the Post Offer section of our FAQ page. Job-related concerns identified during the background screening may disqualify you from the new position or your current role. Background results will be evaluated on a case-by-case basis. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Equal Employment Opportunities We are committed to providing equal employment opportunities to all persons regardless of race, color, ancestry, citizenship, national origin, religion, veteran status, disability, genetic characteristic or information, age, gender, sexual orientation, gender identity, gender expression, marital status, family status, pregnancy, or other legally protected status (collectively, “protected statuses”). We do not tolerate unlawful discrimination in any employment decisions, including recruiting, hiring, compensation, promotion, benefits, discipline, termination, job assignments or training. Privacy Notice Lumen is committed to protecting the privacy and security of personal information collected during the recruitment and hiring process. Our Privacy Notice explains how we collect, use, disclose, and protect applicant information, as well as how individuals may request access to or deletion of their personal data. To review Lumen’s Privacy Notice, please visit: https://jobs.lumen.com/global/en/privacy-notice Disclaimer The job responsibilities described above indicate the general nature and level of work performed by employees within this classification. It is not intended to include a comprehensive inventory of all duties and responsibilities for this job. Job duties and responsibilities are subject to change based on evolving business needs and conditions. In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of school attendance or graduation. You will not be penalized for redacting or removing this information. Please be advised that Lumen does not require any form of payment from job applicants during the recruitment process. All legitimate job openings will be posted on our official website or communicated through official company email addresses. If you encounter any job offers that request payment in exchange for employment at Lumen, they are not for employment with us, but may relate to another company with a similar name.
Regulatory Affairs Operations - National Remote
UnitedHealth GroupUnitedHealth Group is a healthcare and well-being company that’s dedicated to improving the health outcomes of millions around the world. We are comprised of
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. Manages regulatory activities and projects in support of company strategies, departments, programs, and functional areas. Responsible for Regulatory Affairs Operations, you will be an individual contributor in our Department of Managed Health Care (DMHC) Affairs team. You will research, document and report on changes in the health care system. This is the challenge of a lifetime. Join us by applying today. Work hours are based on California Pacific Time, Monday – Friday, 8:00am – 5:00pm. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities: - Respond to inquiries, requests, notifications, and actions by regulatory agencies, including complaints and requests for assistance - Perform critical and objective review of new laws, research existing regulations, and guidance to support effective decision making and action steps - Collaborate with colleagues, coordinate and implement applicable project plans - Provide regular updates on progress, anticipate areas of difficulty, potential risks, contribute towards creative solutions, and move to action quickly - Manage/implement applicable regulatory filings (e.g. routine reports, maintenance of confidentiality) in a timely manner - Oversee data collection, utilizing appropriate tools and processes to track, trend, and analyze regulatory metrics - Perform supportive administrative and operational activities, including developing and distributing departmental communications - Identify opportunities for standardization, coordinate implementation of best practices, and process improvement You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. - High School Diploma/GED (or higher) - 2+ years of experience working in health care, managed care and/or health insurance - 2+ years of experience with regulatory affairs or compliance - 2 + years of experience in responding to inquiries from a variety of stakeholders (external customers, internal customers, executives and regulators) - 2+ years of experience in communicating and understanding complex information - 2+ years of demonstrated experience detail oriented and able to prioritize and organize own work to meet deadlines - 2+ years of demonstrated experience and ability to adapt in a fast-paced environment with shifting priorities - Advanced level of experience with Microsoft office (Excel, Word, PowerPoint) Preferred Qualifications: - Understanding of California DMHC, DHCS, and CMS Regulations - Previous experience as executive/administrative assistant, or legal assistant - Experience creating flow charts/org charts *All Telecommuters will be required to adhere to UnitedHealth Group’s Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you’ll find a far-reaching choice of benefits and incentives. The salary for this role will range from $60,200 to $107,400 annually based on full-time employment. We comply with all minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location, and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission. UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN
Operations Coordinator
PavagoPavago specializes in connecting businesses with top-tier offshore talent in operations, sales, and marketing, offering a comprehensive recruitment solution designed to reduce cost
Job Title: Operations Coordinator Position Type: Full-Time, Remote Working Hours: U.S. client business hours About the Role: Our client is seeking an Operations Coordinator to provide day-to-day support across core business functions. This role ensures that operations run smoothly by managing workflows, maintaining records, monitoring KPIs, and serving as a bridge between departments. The Operations Coordinator creates clarity, consistency, and efficiency in the daily running of the organization. Responsibilities: Process Coordination: - Track workflows across departments (finance, HR, customer service, logistics, IT). - Ensure operational tasks are completed on schedule and according to SOPs. - Escalate bottlenecks or inefficiencies to management. Data & Reporting: - Maintain operational databases and dashboards. - Generate weekly/monthly reports on KPIs such as productivity, resource utilization, and cost efficiency. - Ensure all reporting is accurate, timely, and actionable. Documentation: - Maintain and update SOPs, process maps, and compliance documentation. - Organize digital files in systems such as SharePoint, Google Drive, or Notion. Vendor & Partner Coordination: - Manage vendor communication, track service delivery, and ensure invoices are routed/approved. - Monitor vendor SLAs and escalate issues. Cross-Department Support: - Coordinate between teams to align on projects, events, or recurring tasks. - Support leadership with ad hoc operational projects and research. Compliance & Controls: - Ensure daily operations adhere to compliance and quality standards. - Maintain accurate logs for audits or internal reviews. What Makes You a Perfect Fit: - Strong multitasker who thrives on organization and accountability. - Analytical mindset with ability to spot trends and inefficiencies. - Clear communicator who can work across functions. - Comfortable balancing routine tasks with special projects. Required Experience & Skills (Minimum): - 2+ years in operations, coordination, or business support roles. - Proficiency with Microsoft Office/Google Workspace. - Familiarity with ERP, CRM, or operational systems (Salesforce, HubSpot, NetSuite, or equivalent). - Strong Excel/Google Sheets skills (dashboards, pivot tables, KPI tracking). Ideal Experience & Skills: - Background in process improvement (Lean, Six Sigma, Kaizen, etc.). - Experience preparing SOPs and operational documentation. - Exposure to data visualization tools (Power BI, Tableau, Looker). - Industry experience in services, SaaS, logistics, or professional firms. What Does a Typical Day Look Like? An Operations Coordinator’s day is defined by keeping business functions aligned, efficient, and on track. You will: - Monitor workflows across multiple departments to ensure daily tasks and projects are completed on time. - Update operational dashboards with the latest data and distribute KPI reports to management. - Maintain accurate records and SOPs, ensuring documentation reflects current practices. - Communicate with vendors and partners to confirm service delivery, resolve issues, and track SLAs. - Coordinate cross-departmental projects, following up on action items and escalating risks. - Support leadership with ad hoc analysis, reporting, or operational initiatives. In essence: you act as the glue of the organization’s operations, ensuring processes are efficient, information is accurate, and leadership has visibility into daily performance. Key Metrics for Success (KPIs): - On-time completion of operational workflows. - Accuracy of KPI reporting and dashboards. - Zero missed vendor/service obligations. - SOPs and records consistently updated and audit-ready. - Positive feedback from stakeholders on communication and coordination. Interview Process: - Initial Phone Screen - Video Interview with Pavago Recruiter - Practical Task (e.g., create a weekly KPI dashboard or process tracker from sample data) - Client Interview - Offer & Background Verification


