HC * Insurance Operations Associate

This position is eligible for company benefits including medical, dental, and vision insurance with an employer contribution, flexible spending or health savings account, life and AD&D insurance, short- and long-term disability coverage, paid time off, employee assistance, participation in a 401k program with company match, and additional voluntary or legally required benefits. Pay for this role is $17.00hr Basic Qualifications: 6 Months of experience in claims adjudication, insurance operations, or related roles Experience in healthcare, disability, life, auto, or property & casualty claims (preferred, role dependent) 6 Months of Work from home environment High school diploma or GED Preferences. Responsibilities: Review and adjudicate insurance claims to determine eligibility, coverage, and payment accuracy Interpret policy language, benefits schedules, and governing regulations to ensure correct claim outcomes Analyze claim documentation and supporting materials to verify completeness and accuracy Identify discrepancies, missing information, or potential fraud and take appropriate action Communicate claim decisions clearly to customers, providers, and internal stakeholders Ensure claims are processed within defined service level agreements (SLAs) Maintain accurate claim records and documentation in claims processing systems Collaborate with quality, compliance, and audit teams to support continuous improvement Strong attention to detail and analytical skills Solid understanding of insurance policies, benefits, and claims procedures Ability to interpret complex regulations and contractual language Effective written and verbal communication skills Ability to manage high claim volumes in a fast-paced environment Proficiency with claims processing systems and Microsoft Office tools Strong problem-solving and decision-making abilities Adhere to privacy, confidentiality, and regulatory standards at all times  New hire must have a working device (such as cell phone or tablet) for the 2-Factor Authentication process Must Pass Drug screen Must Pass a background check with Education check and employment verification check.  Required schedule availability for this position is Monday-Friday 6:00 am ct to 6:00 pm (Central Time),   Remote Working and Technology Requirements To work remote, individuals must meet all the established Remote requirements including those pertaining to a home workspace and related technology. Technology NTT DATA will provide a computer and headset for remote work. Employees are responsible for the care and security of all equipment provided. They must return it immediately upon separation from the company following company protocols. Failure to return equipment may result in collection actions and/or other consequences. Individuals must provide their own high speed internet access with speeds at or above 50 Mbps. A hard-wired ethernet connection is required. Wi-Fi, mobile, wireless and public internet connections are forbidden as are connections outside of one’s personal dwelling or location. Technical Performance and Issue Tracking Management monitors all technical issues and agent downtime. Consistent availability is critical to business operations. Remote employees must adhere to all technical support procedures and protocols. Chronic connectivity issues or recurring downtime that impede job performance, including internet outages, may result in the remote status changing to onsite. Remote Workspace Remote work demands a high degree of professionalism, self-discipline, and accountability. The following workspace standards are vital to delivering exceptional service. Employees must have a  dedicated, professional workspace  conducive to servicing Customer Service customers with the same quality as an onsite environment. The workspace must be a  permanent, unencumbered location  used daily for work. Employees must work with  minimal distractions  that do not interfere with business operations or service delivery. Ideally, the workspace is  isolated from other household members  and used exclusively for job duties. Background noise, interruptions from people or pets, and other distractions  must be kept to an absolute minimum to avoid disruptions to customer service. Employees must work from the  same location consistently  unless prior approval is obtained. If a change in work location is necessary: The new location must meet all  Remote Workspace and Technology Requirements . Notification to NTT DATA Management  is required before relocating