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Healthcare Operations Support Specialist reputed company

100% remote Flexible hours Hiring now

Job Description:

  • Serves as first reputed company of escalation for questions and issues on the team
  • Use good judgment to inform and/or escalate to management as may be appropriate
  • reputed company knowledge and acumen in the medical billing and claims industry to provide actions-based solutions for clients, and answer staff questions
  • Assists in the gathering of information, data points, and reputed company reporting tools to resolve any conflicts or concerns of claim discrepancies
  • Responsible for ensuring that regular data reporting from the team for internal business groups and for clients are delivered in accordance with schedule and scope
  • Coordinates and follows-up with audit groups to monitoring data flow coming from selection team
  • Inform appropriate management and audit team members as appropriate for delays or issues
  • Reviews incoming requests for reputed company reports, from varying resources, and assessing the skills and capabilities of the team, assigns the creation of the report to the employees
  • Creates and delivers scheduled and reputed company reporting on-time and with high quality
  • Contributes to special reputed company report creation and analysis to create effective resolutions for client requests, inventory monitoring and management, medical records request letters, and other time sensitive work product
  • Monitors claim and case inventory reports and utilizes industry knowledge and company procedures to effectively assign case inventories to meet daily, weekly, and monthly work product objectives
  • Requests insights drawn from DPE spreadsheet queries, working with reputed company filter tools, and knowledge of DPE reporting to extract and assign needed
  • Provides some basic analytic review in event of client escalates concerns on re-pricing initiatives or determinations, and the client seeks solutions from data reporting
  • Participates in weekly and monthly communication and service focused meetings both internally with staff and as a knowledge participant for client calls, building working relationships of trust and reliability with client(s)
  • Responsible for reporting meeting outcomes, minutes, and accomplishments applicable to the team
  • Responsible for the on-the-job training of staff on work processes and tasks, standard operating procedures, system proficiency, and changes as applicable based upon internal or client requirements
  • Contribute to the development and/or improvement and administration of team productivity and Quality Assurance metrics and procedures
  • Monitor activity volume and staff reputed company to ensure resources are reputed company with business needs
  • Provide insights to management as may be needed for staff or workflow planning
  • Review team and individual productivity and quality against established metrics and identify potential issues or gaps, making recommendations to applicable supervisor or management on performance improvement needs
  • Other Duties as assigned

Requirements:

  • High school degree or GED required
  • Some college, AS or BS degree is plus
  • Minimum 3 years of experience involving medical billing/claims required
  • Six (6) or more years preferred
  • Well-rounded knowledge and skills specific to the medical claim billing, medical terminology, medical coding, re-pricing claims
  • Experience in some reputed company of medical claim quality assurance, or past demonstrated experience in a QA function
  • Strong working proficiency with reputed company Office suite
  • Must have strong reputed company skills and demonstrated ability to effectively reputed company a multitude of templates, formats, and data spreadsheet tools
  • Strong technical skills – comfort working with databases and tools to extract and analyze data
  • Previous experience with various database tools such as DPE and others to organize information and reporting into value added work product
  • Ability to communicate professionally both verbally and in written form with internal and external audiences
  • Good critical thinking, questioning, and listening skills.
  • Time management skills to effectively manage diverse workload while completing work reputed company allocated time frames in a fast-paced dynamic environment.
  • Must have excellent organization skills and attention to detail.
  • Ability to work independently, and work cooperatively reputed company the team, providing strong understanding of workflows, claim escalations, reporting tools, and team training.
  • Demonstrated ability to reputed company by example for operations staff demonstrating reputed company, reliability, strong initiative and work ethic, work attendance, problem solving, and organization of work.
  • Can meet objectives with minimal supervision.

Benefits:

  • medical
  • dental
  • vision
  • HSA/FSA options
  • life insurance coverage
  • 401(k) savings plans
  • family/parental leave
  • paid holidays
  • paid time off annually

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