SUMMARY: The Claims Team Lead is responsible for the reconciliation of the provider’s reimbursement request forms. In addition, he/she will be responsible for maintaining all departmental filing and other duties that may be assigned.
ESSENTIAL FUNCTIONS
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Correlate the reimbursement request forms and resubmissions by provider per day in chronological order.
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Approvals and denial for reimbursement and resubmissions.
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Data entry.
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Responsible for generating and distributing copies of denied reimbursement requests to providers.
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Filing all reimbursement forms.
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Assisting with special rates from the call center.
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Relays instructions, messages and other information as requested from the management team.
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Maintains a current working knowledge of all company policies, procedures, rules, regulations and memorandums.
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Responsible and accountable for updating management on changes and/or extraordinary circumstances affecting the company and/or transportation provider.
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Other duties as assigned by management team.
REQUIRED SKILLS AND ABILITIES
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Excellent communications skills oral and written.
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Able to work in a busy environment.
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Able to function effectively in stressful situations.
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Knowledge of reconciliation and customer service policies and procedures.
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Knowledge of Medicaid Non-Emergency Transports preferred.
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Able to handle multiple tasks simultaneously.
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Computer experience.
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Following training, able to adequately implement concepts of Route Logic.
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Able to lift and/or move items up to 25 pounds.
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Must be able to key 8000+ keystrokes.
QUALIFICATION
