Clinical Data Associate Jobs in Pawtucket, RI (NOW HIRING)

Req ID: 384911 

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 TEMP BPO Associate to join our team in Lincoln, Rhode Island (US-RI), United States (US).

As a Rep II, Operations, you will support Medicare members, prescribers, and providers by processing coverage-related requests across both phone and fax (offline) channels. This role integrates responsibilities previously segmented by channel (phone vs. fax) and line of business (Medicare Part D and applicable Medicare Part B processes), reflecting the organization's modularized training model in which colleagues progressively learn, practice, and apply endtoend skills before fully transitioning to production work.
In this role, you will be responsible for accurate case setup, review, outreach, documentation, and timely resolution of requests in accordance with Medicare guidelines, CMS-mandated timelines, and internal quality standards. You will demonstrate strong attention to detail, professional verbal and written communication skills, and the ability to problem-solve in a highly regulated, fast-paced environment. Work will be performed through a combination of inbound and outbound phone interactions and fax-based casework. Colleagues are trained across both phone and fax-based workflows and progressively apply learned skills through practice before full production deployment.
Responsibilities:
Process incoming coverage-related requests (e.g., prior authorizations, coverage determinations, drug benefit exceptions, appeals) via phone and fax from members and prescribers.
Accurately set up cases, review documentation, and apply work instructions to ensure correct and timely processing.
Read, analyze, and interpret business correspondence, technical procedures, and Medicare regulations to support decision-making.
Conduct outbound calls to members and providers to obtain missing or additional information required to complete requests.
Communicate clearly, professionally, and empathetically while projecting a positive business image.
Provide clear, concise, and accurate documentation of all case activity across systems.
Ensure all cases are properly closed and meet CMS-mandated timelines, department productivity expectations, and quality standards.
Identify and research issues in the overall process and correct errors when identified.
Raise complex issues or clinical questions to Coverage/Organization Determination Clinical Pharmacists or management as appropriate.
Collaborate with peers, trainers, and leaders while progressing through modular training and skill expansion.
Acquire and maintain working knowledge of evolving work instructions, systems, and Medicare guidance (Part D and applicable Part B processes).
Participate in coaching, feedback, and development discussions with direct leadership.
Required Qualifications:

• 1+ years working in a healthcare or pharmacy customer service focused role
• 1+ years customer service, Call center experience a plus
• 2+ years MS office in an office environment

Education:

• High school diploma or GED required

About NTT DATA

NTT DATA is a $30 billion business and technology services leader, serving 75% of the Fortune Global 100. We are committed to accelerating client success and positively impacting society through responsible innovation. We are one of the world's leading AI and digital infrastructure providers, with unmatched capabilities in enterprise-scale AI, cloud, security, connectivity, data centers and application services. our consulting and Industry solutions help organizations and society move confidently and sustainably into the digital future. As a Global Top Employer, we have experts in more than 50 countries. We also offer clients access to a robust ecosystem of innovation centers as well as established and start-up partners. NTT DATA is a part of NTT Group, which invests over $3 billion each year in R&D.

Whenever possible, we hire locally to NTT DATA offices or client sites. This ensures we can provide timely and effective support tailored to each client's needs. While many positions offer remote or hybrid work options, these arrangements are subject to change based on client requirements. For employees near an NTT DATA office or client site, in-office attendance may be required for meetings or events, depending on business needs. At NTT DATA, we are committed to staying flexible and meeting the evolving needs of both our clients and employees. NTT DATA recruiters will never ask for payment or banking information and will only use @nttdata.com, @nttdatafed.com and @talent.nttdataservices.com email addresses. If you are requested to provide payment or disclose banking information, please submit a contact us form, https://us.nttdata.com/en/contact-us.

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