Title: Claims Examiner - Xcelys Remote, Temporary Location: Ontario, CA, United States Job Description: Req ID: 366967 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 Claims Examiner - Xcelys Remote, Temporary to join our team in Ontario, California (US-CA), United States (US). Senior Claims Auditor (Xcelys System) To serve as a Medical Claims Processor within the Xcelys environment. Provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations. Role Responsibilities: - Adjudication & Review - Process comprehensive medical claims using Xcelys and associated subsystems - Resolve complex pends, coding issues, and contract exceptions - Author overpayment/underpayment determinations and coordinate appeals - Quality & Compliance - Engage in quality reviews, audits, root cause analyses - Monitor accuracy, variance, and rework metrics - Ensure alignment with regulatory and internal compliance guidelines - Support - Act as escalation point and subject matter expert - Process & System Improvement - Participate in system testing, UAT, and workflow enhancements - Recommend improvements, document system and process changes - Reporting & Analytics - Prepare production, pending, and quality reports - Identify trends and recommend corrective actions - Cross-Functional Collaboration - Liaise with provider relations, legal, IT, compliance teams - Support internal initiatives related to claims systems / operational improvements Required Skills/Experience - 3+ years claims adjudication experience - Minimum of 1 year experience in Xcelys - 2+ years in coding (CPT, ICD-10, HCPCS) - 2+ years provider contracts, pricing, regulatory guidelines experience Preferences - Excellent analytical and communication skills - Experience training staff or acting as a mentor - Familiarity with system testing and documentation - Ability to manage high-volume workload and meet performance metrics Education: Verifiable high school diploma or GED 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. 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.

Claims Analyst I Employee Type: Contract Location: San Diego, CA, US Job Type: Pay Range: $22 - $26 per hour Job Description: Job#: 3031279 Job Description: Claims Analyst I Location: San Diego, CA Schedule: 4 days onsite, Fridays remote Hours: Flexible start time (as early as 6:00 AM or later start available) Openings: 2 Contract: 2‑year contract with strong potential for conversion based on performance and budget Position Overview We are seeking a Claims Analyst I to support general liability, bodily injury, motor vehicle, property damage, and subrogation claims. This role is ideal for an insurance professional who can investigate losses, clearly communicate complex scenarios, and help drive fair and timely claim resolutions. The Claims Analyst will pursue recovery from third parties responsible for damage to company facilities, property, or equipment and support general liability claims involving personal injury or property loss. Structured onboarding, including shadowing and hands‑on training, is provided. Key Responsibilities - Investigate, analyze, and pursue subrogation recovery against third parties responsible for damage to facilities, property, or equipment - Support general liability claims by investigating incidents, analyzing exposure, and determining insurance liability related to bodily injury or property damage - Negotiate and attempt to resolve claims with insurers, claimants, and other stakeholders - Set up and manage claims in internal systems, ensuring accuracy and compliance - Review claims payment reports for correctness and compliance - Oversee claims processing and payments to third‑party providers - Monitor charges, verify appropriate payments, and issue denial letters when applicable - Send follow‑up requests for additional or missing documentation - Maintain thorough, accurate claim documentation and files - Communicate complex claim information clearly and effectively, both verbally and in writing Required Qualifications - Minimum 3 years of experience in insurance claims, including experience with: - Subrogation - Motor vehicle accidents - Personal / bodily injury - Property damage - General liability claims - Strong written and verbal communication skills - Ability to simplify complex claim matters - Proven ability to influence, negotiate, and drive outcomes - Bachelor’s degree preferred; years of experience accepted in lieu of degree Preferred Background - Prior experience with insurance carriers such as GEICO, State Farm, Farmers, Liberty Mutual, Progressive, or similar organizations - Experience working in a structured or high‑volume claims environment Additional Details - Equipment provided (laptop and monitor for office and home use) - One interview round with the hiring manager and an additional supervisor - Structured training program, including shadowing and on‑the‑job learning Apex Systems is a world-class IT services company that serves thousands of clients across the globe. When you join Apex, you become part of a team that values innovation, collaboration, and continuous learning. We offer quality career resources, training, certifications, development opportunities, and a comprehensive benefits package. Our commitment to excellence is reflected in many awards, including ClearlyRated's Best of Staffing® in Talent Satisfaction in the United States and Great Place to Work® in the United Kingdom and Mexico. Apex uses a virtual recruiter as part of the application process. Apex Benefits Overview: Apex offers a range of supplemental benefits, including medical, dental, vision, life, disability, and other insurance plans that offer an optional layer of financial protection. We offer an ESPP (employee stock purchase program) and a 401K program which allows you to contribute typically within 30 days of starting, with a company match after 12 months of tenure. Apex also offers a HSA (Health Savings Account on the HDHP plan), a SupportLinc Employee Assistance Program (EAP) with up to 8 free counseling sessions, a corporate discount savings program and other discounts. In terms of professional development, Apex hosts an on-demand training program, provides access to certification prep and a library of technical and leadership courses/books/seminars once you have 6+ months of tenure, and certification discounts and other perks to associations that include CompTIA and IIBA. Apex has a dedicated customer service team for our Consultants that can address questions around benefits and other resources, as well as a certified Career Coach.

• Investigate assigned claims reported under insurance contracts provided by affiliated Companies • Identify information and documents needed to evaluate claims • Assign and direct independent adjusters • Contact Insureds, Claimants regarding claims processes and resolution alternatives • Comply with claims handling laws and regulations • Identify and determine respective rights and obligations under insurance contracts • Analyze, evaluate, and estimate liability of Insureds and loss of Claimants/Insureds • Establish and modify appropriate case reserve reflecting information regarding assigned claims • Prepare and maintain accurate record of communications with Insureds and Claimants

Pie's mission is to empower small businesses to thrive by making commercial insurance affordable and as easy as pie. We leverage technology to transform how small businesses buy and experience commercial insurance. Like our small business customers, we are a diverse team of builders, dreamers, and entrepreneurs who are driven by core values and operating principles that guide every decision we make. The Claims Adjuster will play a vital role in delivering quality claim file management and an industry-leading customer claims experience. This will be completed by adhering to Pie’s Claims Best Practices and complying with regulatory and statutory requirements. This role will work with internal and external partners to deliver best in class performance, identify and pursue claim mitigation opportunities and deliver favorable claim outcomes for Pie’s customers. How You’ll Do ItClaims Technical Management: - Independently handle all aspects of the workers’ compensation claims from set-up to closure. - Conduct timely 3-point contact investigation, with focus on continued investigation as facts of the case change. - Mitigate claim exposure while achieving the best outcome. - Determine timely and accurate compensability decisions within statutory requirements. - Set and adjust timely/accurate reserves within authority limits to ensure reserving activities are consistent with the case facts and company best practices. - Timely administration of statutory medical and indemnity benefits throughout the life of the claim. - Comply with all applicable statutory guidelines, rules, and regulations. - Control legal activity with defense counsel through the litigation process while managing legal fees and costs. - Prioritize early resolution opportunities, evaluate claim exposure and negotiate settlement. Claims Customer Service: - Serve as a point of contact for our partner agents and customers to provide general claim guidance and help set claim process expectations. - Assist as necessary in providing claim status to agents and insureds, coverage verification and loss run reports, etc. - Provide excellent customer service to internal and external customers and business partners. - Participate in interactions with TPA adjusters and claims partners to drive optimized claims outcomes and top-notch claims experience. - Advocate to ensure that Pie has a leading claims customer experience. - Work to continuously improve our claims operations and look at opportunities and gaps in claim service, handling SOPs, protocols and processes. The Right Stuff - High School Diploma or equivalent is required. - Bachelor's Degree or equivalent experience with some college coursework is preferred. - Minimum of 2-years workers’ compensation claims experience is required. - Claims experience working in CA is required. - Strong communication (written and verbal) skills, to deliver more complex information effectively. - Strong problem solving skills to be able to manage complex tasks and work through to solutions with little guidance and direction. - Awareness of your own tasks, and how it impacts the team and deliverables. - Experience using G-Suite Tools, and collaboration tools like Slack is preferred. - Knowledge of jurisdictional regulatory and statutory requirements and CMS/MSA requirements. - Demonstrated knowledge and experience in claim adjudication, medical management and litigation management. - Developing ability to analyze and take necessary action in multiple focus areas, based on several data points. - Ability to use skills to overcome conflict and reach beneficial outcomes. - Ability to make claim decisions to mitigate exposure while achieving the best outcome. The use of AI in Application Review: To support a fair, efficient, and consistent hiring process, we use AI-powered tools to assist in the initial screening of applications. These tools help us identify qualifications and prior work experiences that align with the requirements of the role. We may also use AI assistant video tools during interviews to support note-taking and candidate evaluation. All AI-powered outputs are still subject to human oversight and decision-making at multiple stages of the process. By submitting your application, you acknowledge and consent to Pie utilizing these AI technologies to assist in our evaluation process. Base Compensation Range $80,000—$100,000 USD Compensation & Benefits - Competitive cash compensation - A piece of the pie (in the form of equity) - Comprehensive health plans - Generous PTO - Future focused 401k match - Generous parental and caregiver leave - Our core values are more than just a poster on the wall; they’re tangibly reflected in our work Our goal is to make all aspects of working with us as easy as pie. That includes our offer process. When we’ve identified a talented individual who we’d like to be a Pie-oneer , we work hard to present an equitable and fair offer. We look at the candidate’s knowledge, skills, and experience, along with their compensation expectations and align that with our company equity processes to determine our offer ranges. Each year Pie reviews company performance and may grant discretionary bonuses to eligible team members. Location Information Unless otherwise specified, this role is remote. Remote team members must live and work in the United States (territories excluded) and have access to reliable, high-speed internet. Additional InformationPie Insurance is an equal opportunity employer. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, or other protected characteristic. Pie Insurance participates in the E-Verify program. Please click here, here and here for more information. Pie Insurance is committed to protecting your personal data. Please review our Privacy Policy. Safety First: Pie Insurance is committed to your security during the recruitment process. We will never ask you for credit card information or ask you to purchase any equipment during our interview or onboarding process. Pie Named to 2025 America's Best Startup Employers Pie Insurance 2025 State of Workplace Safety Report #LI-REMOTE #BI-REMOTE