Claims Examiner - Xcelys Remote, Temporary

Job description

Req ID: 365466 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 Examiner (Xcelys System): To serve as a senior-level adjudicator and SME for medical claims within the Xcelys environment. Provide subject-matter expertise on claims workflows and be a key contributor to system enhancements, audits, and process optimizations. Key Duties & Responsibilities: Required / Preferred Skills & Experience - 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 -...