A Processor is an integral part of ensuring member coverage is accurate and up to date. They will work in client services to update membership information, documenting work where appropriate and providing membership updates as applicable to the business in compliance with all Federal and State Healthcare laws.
Essential Duties and Responsibilities (include but are not limited to):
- Updates membership files and documents records according to company policies and procedures.
- Maintains quality customer service, with high attention to detail and accuracy.
- Ensures legal compliance by following company policies and procedures, as well as state and federal insurance regulations.
- Ensure proper payments transactions are completed and issues refunds when required.
- Reviews coverage plans, applications and membership files to ensure completeness and accuracy.
- Consult policy files and member profiles to verify information is correct.
Required Knowledge & Skills
- Excellent communication (verbal and written) and customer service skills.
- Detail-oriented; ability to organize and multi-task, work under pressure and manage fluctuating workloads.
- Ability to read, interpret and make decisions based on specific plan documents and procedure manuals.
- Proven experience in using judgment and problem solving skills to deal with concrete variables in an environment where limited standardization may exist.
- Basic office equipment experience including: computer, printer, copier, telephone/fax, typing at least 30 WPM.
- Has a solid understanding of basic math functions- addition, subtraction, multiplication and division.
- Demonstrate strong reading comprehension, writing skills and data entry.
Experience and Training:
- Education: High School Diploma or equivalent.
- Minimum 6 months experience with Customer Service.
- Computer proficiencies are required, including MS Work, Excel and Outlook.
- Medical Benefits and Medical billing experience preferred.
- Must be in good standing with the company in current position.
Generally works in office environment.
Essential functions may require maintaining physical condition necessary for standing, walking, sitting, use hands and fingers to handle, or feel and reach. Vision abilities include close vision and ability to adjust focus.
- Sitting for long periods
- Repetitive hand/finger motion (using keyboard)
- Stressful Situations with time constraints
The statements above are intended to describe the general nature and level of work being performed by people assigned to this job. Other duties may be assigned as needed. Firstsource Transaction Services, INC. is an equal opportunity employer that does not discriminate on the basis of age (40 & over), race, color, religion, sex, national origin, protected veteran status, disability, sexual orientation, gender identity or any other protected class in accordance with applicable law.
Job Type: Full-time
- Relevant: 1 year (Preferred)