Xcelys Medical Claims Examiner
NTT DATA North America • winnipeg, Canada
Role Description
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 EXPERIENCE
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 escalatio...