Green Card Medical Claims Examiner Jobs
Medical Claims Examiner roles qualify for EB-2 and EB-3 green card sponsorship through the PERM labor certification process, where employers document that no qualified U.S. worker is available before filing an I-140 petition. Health insurers, third-party administrators, and managed care organizations regularly sponsor foreign professionals in this role.
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Get Access To All JobsINTRODUCTION
NTT DATA is currently seeking Senior Medical Claims Examiners (3+ years of Xcelys required) to join our U.S. based team. This is a 100% remote role.
Must be able to work 8: 00 am-5:00 pm Pacific time zone
PURPOSE:
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.
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 escalation point and subject matter expert
Process & System Improvement:
- Participate in system testing, UAT, and workflow enhancements
- Recommend improvements, document system and process changes
Reporting & Analytics:
- Prepare production, pending, and quality reports
- Identify trends and recommend corrective actions
Cross-Functional Collaboration:
- Liaise with provider relations, legal, IT, compliance teams
- Support internal initiatives related to claims systems / operational improvements
SUCCESS MEASURES / KPIs
- Claims processed per day / throughput
- Accuracy / audit scores
- Rework / error rate
- Turnaround time for pends / escalations
- Contribution to system / process enhancements
- Feedback from peer and leadership reviews
REQUIRED:
- 5+ years claims adjudication experience
- 3+ years of experience in Xcelys claims adjudication systems
- Expertise in coding (CPT, ICD-10, HCPCS)
- Deep knowledge of provider contracts, pricing, regulatory guidelines
- Excellent analytical and communication skills
- Experience training staff or acting as a mentor
- Familiarity with system testing and documentation
- Ability to manage high-volume workload and meet performance metrics
ABOUT NTT DATA:
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. 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.
For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
NTT DATA is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success.
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is $20.00 - $21.00/hourly. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, 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.
INDHRS
LI-NORTHAMERICA
INTRODUCTION
NTT DATA is currently seeking Senior Medical Claims Examiners (3+ years of Xcelys required) to join our U.S. based team. This is a 100% remote role.
Must be able to work 8: 00 am-5:00 pm Pacific time zone
PURPOSE:
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.
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 escalation point and subject matter expert
Process & System Improvement:
- Participate in system testing, UAT, and workflow enhancements
- Recommend improvements, document system and process changes
Reporting & Analytics:
- Prepare production, pending, and quality reports
- Identify trends and recommend corrective actions
Cross-Functional Collaboration:
- Liaise with provider relations, legal, IT, compliance teams
- Support internal initiatives related to claims systems / operational improvements
SUCCESS MEASURES / KPIs
- Claims processed per day / throughput
- Accuracy / audit scores
- Rework / error rate
- Turnaround time for pends / escalations
- Contribution to system / process enhancements
- Feedback from peer and leadership reviews
REQUIRED:
- 5+ years claims adjudication experience
- 3+ years of experience in Xcelys claims adjudication systems
- Expertise in coding (CPT, ICD-10, HCPCS)
- Deep knowledge of provider contracts, pricing, regulatory guidelines
- Excellent analytical and communication skills
- Experience training staff or acting as a mentor
- Familiarity with system testing and documentation
- Ability to manage high-volume workload and meet performance metrics
ABOUT NTT DATA:
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. 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.
For more than 25 years, NTT DATA Services have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms, we deliver continuous value addition, and innovation that will improve your business outcomes. Outsourcing is not just a method of gaining a one-time cost advantage, but an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy.
NTT DATA is a recognized leader in IT and business services, including cloud, data and applications, headquartered in Texas. As part of NTT DATA, a $30 billion trusted global innovator with a combined global reach of over 80 countries, we help clients transform through business and technology consulting, industry and digital solutions, applications development and management, managed edge-to-cloud infrastructure services, BPO, systems integration and global data centers. We are committed to our clients' long-term success.
NTT DATA is an equal opportunity employer and considers all applicants without regarding to race, color, religion, citizenship, national origin, ancestry, age, sex, sexual orientation, gender identity, genetic information, physical or mental disability, veteran or marital status, or any other characteristic protected by law. We are committed to creating a diverse and inclusive environment for all employees. If you need assistance or an accommodation due to a disability, please inform your recruiter so that we may connect you with the appropriate team.
Where required by law, NTT DATA provides a reasonable range of compensation for specific roles. The starting hourly range for this remote role is $20.00 - $21.00/hourly. This range reflects the minimum and maximum target compensation for the position across all US locations. Actual compensation will depend on several factors, including the candidate's actual work location, relevant experience, technical skills, and other qualifications.
This position is eligible for company benefits that will depend on the nature of the role offered. Company benefits may include medical, dental, and vision insurance, 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.
INDHRS
LI-NORTHAMERICA
Tips for Finding Green Card Sponsorship in Medical Claims Examiner
Credential your healthcare billing certifications first
PERM requires your employer to prove your qualifications meet the posted job requirements. A Certified Professional Coder or Certified Claims Examiner credential on your resume strengthens the employer's case and reduces RFE risk on the I-140.
Target TPAs and self-insured employer plans
Third-party administrators and large self-insured plan sponsors process high claims volumes and maintain dedicated HR infrastructure for employment-based sponsorship. They're more likely to have established PERM workflows than smaller regional carriers.
Check the OFLC Wage Search before salary discussions
PERM filings must meet the DOL prevailing wage for your specific SOC code and geographic area. Reviewing the OFLC Wage Search before negotiating your offer ensures the employer's proposed salary is certifiable and avoids delays at the labor certification stage.
Use Migrate Mate to find verified green card sponsors
Search for Medical Claims Examiner roles with documented EB-2 and EB-3 filing history using Migrate Mate. The platform surfaces employers who have previously completed PERM certifications for this role, so you're not guessing at sponsorship willingness.
Clarify sponsorship timing before accepting any offer
Ask your prospective employer whether they initiate PERM during your first year or only after a probationary period. Delays past the second year can affect your priority date and complicate your timeline if you're currently on a temporary work status.
Request EB-3 filing if your degree is a bachelor's
Medical Claims Examiner roles typically qualify under EB-3 as a skilled worker or professional. If your employer's immigration counsel initially proposes EB-2, confirm that your degree and experience actually satisfy the advanced-degree standard to avoid a USCIS denial on classification grounds.
Green Card Medical Claims Examiner: Frequently Asked Questions
Do Medical Claims Examiner roles typically qualify for EB-2 or EB-3 green card sponsorship?
Most Medical Claims Examiner positions qualify under EB-3 as skilled workers or professionals, requiring at least a bachelor's degree or two years of specialized training. EB-2 sponsorship is available if the employer genuinely requires an advanced degree for the role and can document that requirement. Your employer's immigration counsel will determine the correct classification based on the actual job duties and minimum requirements posted during the PERM recruitment process.
How does green card sponsorship differ from H-1B sponsorship for this role?
Unlike H-1B visa, employment-based green card sponsorship through PERM leads to permanent residency rather than a temporary status with renewal requirements. There is no annual lottery for EB-3 green cards, and most countries outside India and China face no significant backlog at that preference level. The process takes longer overall, typically two to four years from PERM filing to an approved I-485 for most nationalities, but the outcome is lawful permanent residency rather than a capped, renewable work authorization period.
What does the PERM labor certification process require from a Medical Claims Examiner applicant?
Your employer conducts the PERM process, not you, but your qualifications directly affect it. DOL requires the employer to advertise the role and demonstrate no qualified U.S. worker was available. Your credentials, including claims processing experience and any healthcare billing certifications, must match the minimum requirements posted in those recruitment steps. Any discrepancy between your actual credentials and the posted requirements can cause a denial or audit at the PERM stage.
How do I find Medical Claims Examiner employers who actively sponsor green cards?
Start with Migrate Mate, which aggregates employer green card filing history so you can identify health insurers, third-party administrators, and managed care organizations that have completed PERM certifications for this specific role. Targeting employers with a documented sponsorship record is significantly more efficient than applying broadly and asking during interviews, where sponsorship questions can be interpreted as premature.
Can I switch jobs after my I-140 is approved but before my green card is issued?
Yes, under AC21 portability provisions, you can change employers after your I-140 has been approved and your I-485 has been pending for at least 180 days, provided the new role is in the same or a similar occupational classification. For Medical Claims Examiner positions, a move to a comparable claims review or healthcare administration role at a different insurer or TPA generally satisfies the portability standard. You should consult an immigration attorney before changing employers to confirm the new role qualifies.