NTT DATA Hiring for Remote Prior Authorization Representative at Remote Full Time

Job Title: Remote Prior Authorization Representative
( Temporary One year or longer)
Industry: Healthcare
FSLA status: Non-Exempt
Department: Operations
Level: Entry to mid-level
Location: Remote
Pay Rate: 17.00-17.75

Where required by law, NTT DATA provides a reasonable range of compensation for specific roles.
The starting pay range for this remote role is 17.00-17.75 per hour. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on a number of factors, including the candidate’s actual work location, relevant experience, technical skills, and other qualifications. This position may also be eligible for incentive compensation based on individual and/or company performance.

At NTT DATA, 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 and for the people who work here.

NTT DATA Services currently seeks a Remote Prior Authorization Representative to join our team for a one year or longer temporary assignment with the possibility of being hired permanently. If you feel you are qualified by the description below, please apply for a chance to interview and discuss your skills & qualifications.

You’ll join and work with a team of talented people who enjoy solving tough problems and improving the healthcare industry. They believe in supporting both personal and professional growth. That means, they pay attention to goals, celebrate milestones and highly encourage learning opportunities.

JOB SUMMARY

Work closely with providers to process prior authorization (PA) and drug benefit exception requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. Must apply information provided through multiple channels to the plan criteria defined through work instruction. Research and conduct outreach via phone to requesting providers to obtain additional information to process coverage requests and complete all necessary actions to close cases. Responsible for research and correction of any issues found in the overall process. Phone assistance is required to initiate and/or resolve coverage requests. Escalate issues to Coverage Determinations and Appeals Learning Advocates and management team as needed. Must maintain compliance at all times with CMS and department standards. Position requires schedule flexibility and additional cross training to learn all lines of business. Flexibility for movement to different parts of the business to support volume where needed.

In this role you will be responsible for:

• Utilizing multiple software systems to complete Medicare Prior Authorization case reviews
• Meeting or exceeding government mandated timelines
• Complying with turnaround time, productivity and quality standards
• Conveying resolution to beneficiary or provider via direct communication and professional correspondence
• Acquiring and maintaining basic knowledge of relevant and changing Med D guidance

JOB QUALIFICATIONS

• 1+ years of healthcare experience
• 1+ years of working with Medicare
• 6 Months PBM/Pharmaceutical experience
• High School Diploma
• Proficient in Microsoft Office Products-Word, and Excel

ESSENTIAL FUNCTIONS
All duties and responsibilities are essential job functions and are subject to possible modification to reasonably accommodate individuals with disabilities. Other functions and accountabilities may be assigned from time to time. Regular attendance is an essential function of this position. To perform this job successfully, the employee will possess the skills, aptitudes, and abilities to perform each duty proficiently.

TYPICAL PHYSICAL DEMANDS
Requires sitting for long periods of time. Some bending, stretching or reaching required.
Requires the physical dexterity to operate a keyboard, calculator, telephone, copier and other office equipment as necessary. Requires ability to perform data entry functions for 95% of the scheduled work shift and perform duties in a fast-paced environment with high demands and tight deadlines. Requires ability to view computer monitor for long periods of time without eyestrain.

About NTT Data, Inc.

NTT DATA, Inc. 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, Inc. is part of the NTT DATA family of companies, together comprising a top 10 global business and IT services provider with

100,000+ professionals in more than 50 countries, and is part of NTT Group, a partner to 85 percent of the Fortune 100. Learn more at https://us.nttdata.com/en/.

EEO Statement

NTT DATA, Inc. (the “Company”) is an equal opportunity employer and makes employment decisions based on 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 genetic information, physical or mental disability, veteran or marital status, or any other class protested 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.

Job Type: Temporary

Pay: $17.00 – $17.75 per hour

Weekly day range:

• Monday to Friday

Work setting:

• Call center
• Remote

Education:

• High school or equivalent (Required)

Experience:

• Medicare: 1 year (Required)
• Healthcare: 1 year (Preferred)
• PBM/Pharmaceutical: 1 year (Preferred)

Shift availability:

• Day Shift (Preferred)

Work Location: Remote