Job Details

ID #15458221
State Illinois
City Decatur
Job type Contract
Salary USD $30 - $40 hr 30 - 40 hr
Source NTT DATA Services
Showed 2021-06-15
Date 2021-06-14
Deadline 2021-08-13
Category Et cetera
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Plan Builder

Illinois, Decatur, 62526 Decatur USA

Vacancy expired!

At NTT DATA Services, we know that with the right people on board, anything is possible. The quality, integrity, and commitment of our employees are key factors in our company s growth, market presence and our ability to help our clients stay a step ahead of the competition. By hiring the best people and helping them grow both professionally and personally, we ensure a bright future for NTT DATA Services and for the people who work here. NTT DATA Services seeks a Benefit Plan Analyst on a project basis to work remote, from home. Summary of PositionThe Benefit Plan Analyst reports to the Chief Administrative Officer. This position will be responsible to ensure, accurate, timely implementation of benefit plans into the claims adjudication system, development, testing, deployment, and documentation of plan/benefit designs for new and existing business. This position will build the plan design within the FIS-SunGard iWork's claim adjudication system using knowledge of benefit design, and data elements. Additionally, the BPA will collaborate and work with the Client Relations Consultant Division regarding implementation, set up and maintenance resulting in assured adherence to desired formulary goals for customer s clients.Essential Duties and Responsibilities

  • Programs benefit plans into adjudication platforms accurately.
  • Establish and maintain plan controls.
  • The job involves elements of quality improvement such as system modifications to improve efficiencies, increase auto adjudication, troubleshooting, etc.
  • Implementation of adjudication rules.
  • Claim testing to ensure accurate claim adjudication.
  • Acts as liaison between internal division and other stakeholders, to coordinate receipt of required information for system programming, reporting and claim adjudication process. This includes the following tasks:
    • Attends implementation meetings to discuss technical requirements and protocols.
    • Maintains working knowledge of home-grown and other systems and procedures.
    • Communicates updates and changes in a timely manner to appropriate stakeholders.
    • Ability to understand reporting requirements and program plan accordingly.
    • Analyzes reports to research and resolve discrepancies, errors, and problems.
    • Provides issue resolution related to benefit plan and/or claims adjudication.
    • Serves as liaison between client technical team and claims adjudication vendor for both routine work and special projects.
  • Creates and maintains plan/benefit design documentation.
  • Works collaboratively with staff to ensure effective communication and is the subject matter expert (or resource) for benefit plan set up and maintenance.
  • Interacts with IT to coordinate plan/benefit design changes.
  • Recommends new and enhanced system logic to support plan/benefit design.
  • Makes recommendations to streamline the work processes, create efficiency and assist with updates.
  • Researches plan/benefit design options and requirements as required.
  • Provides optimum customer service.
Knowledge, Skill, and Abilities:
  • Program/project management experience preferred.
  • A.A. degree or higher desired.
  • Proficient with medical coding including ICD-10, HCPCS, CPT, CDT, Revenue codes.
  • Knowledge of EDI Business Practices for institutional and professional bills.
  • Knowledge of Medical Terminology.
  • Claims processing experience and/or claims auditing.
  • Plan document/ Plan benefit understanding (Health, Dental, STD, Vision, etc.)
  • Strong analytical skills.
  • Knowledge of ACA and HIPAA-the application of regulatory compliance regarding benefits.
  • Excellent verbal and written communication skills.
  • Proficient with multiple computer applications.
  • Experience working with internal and external client personnel.
  • Advanced use of Microsoft Office Products (ex. Excel skills: V-lookups, formulas, ability to create, edit and run reports).
  • Experience in Benefit Plan Administration.
General Expectations
  • Present a positive image of customer at all times.
  • Provide and promote the delivery of services with a prevailing attitude of respect and recognition of the personal worth and dignity of every individual whether they are a customer, co-worker, producer or supervisor.
  • Communicate in a clear and concise manner, while also demonstrating receptivity through active listening.
  • Identify and perform work that has not been specifically assigned, as needed.
  • Adhere to established safety standards and utilizes proper techniques to avoid work-related injuries.
  • Continuously seek opportunities for improvement and suggest ways in which procedures/systems may be modified to accomplish tasks/goal efficiently and effectively.
  • Demonstrate a teamwork philosophy by working cooperatively with others inside and outside the Administration Division.
  • Attend required in-service and staff meetings.
  • Preserve the confidentiality of all business-sensitive information, including but not limited to that of insured groups and individuals, employees and applicants.
About NTT DATA ServicesNTT DATA Services partners with clients to navigate and simplify the modern complexities of business and technology, delivering the insights, solutions and outcomes that matter most. We deliver tangible business results by combining deep industry expertise with applied innovations in digital, cloud and automation across a comprehensive portfolio of consulting, applications, infrastructure and business process services.NTT DATA Services, headquartered in Plano, Texas, is a division of NTT DATA Corporation, a top 10 global business and IT services provider with 118,000+ professionals in more than 50 countries, and NTT Group, a partner to 88 percent of the Fortune 100. Visit nttdataservices.com to learn more.NTT DATA, Inc. (the Company ) is an equal opportunity employer and makes employment decisions on the basis of merit and business needs. The Company will consider all qualified applicants for employment without regard to race, color, religious creed, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other class protected by law. To comply with applicable laws ensuring equal employment opportunities to qualified individuals with a disability, the Company will make reasonable accommodations for the known physical or mental limitations of an otherwise qualified individual with a disability who is an applicant or an employee unless undue hardship to the Company would result.

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