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Claims Submission Specialist in Malvern at Jobs | Lyneer Staffing

Date Posted: 1/2/2019

Job Snapshot

Job Description


Shift: Flex Scheduling

Pay Rate: $16

Claims Submission Specialists

  • As a member of the Production Control team, you will drive speed to payment and improved revenue yield by ensuring all claims are received by the payor timely and accurately.

  • Your day-to-day tasks will include performing root cause analysis on claim submission exceptions, resolving those exceptions, and partnering with internal and external teams to identify innovative ways to prevent future errors.

  • Your efforts will help the company's Revenue Operations (ROPS) group to build a world-class claim submission and reconciliation capability to succeed, you will need to be an analytical problem solver with the ability to build strong partnerships and work collaboratively. You will strive to continuously improve your skill set and knowledge of the revenue cycle in order to best support your partners. Your drive to exceed performance expectations will contribute to accelerated claim submission and exception reduction.

    Responsibilities may include, but are not limited to:

    • Monitor edits, exception, and response reports to identify and ensure successful claim submission
    • Perform root cause analysis and create solutions that resolve exceptions at the source, preventing them from reoccurring in the future
    • Partner with payer representatives, third-party clearinghouses, or internal customers to resolve claims processing or submission issues
    • Identify and communicate claim edit requirements; ensure they are set up appropriately in claims edit software
    • Escalate claim submission issues or trends to leadership as needed

Requirements

  • High School diploma required
  • 2+ years experience in healthcare reimbursement/collections required
  • Intermediate proficiency in Internet and MS Office environments (Word, PowerPoint, Access, Excel, and Outlook) and the ability and desire to advance technically required
  • Talent for tackling problems from identification through resolution
  • Demonstrated strengths in analytical and problem solving skills
  • Strong communications skills; ability to listen attentively and to communicate information clearly and effectively
  • Excellent relationship building skills and aptitude for working collaboratively with cross-functional groups
  • Proven ability to meet deadlines in a fast-paced environment
  • Ability to manage multiple projects, meet deadlines, and adjust priorities appropriately
  • High degree of drive, initiative, and follow through
  • Role model of company values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment, and Fun in everyday performance and interactions

Job Requirements

High School diploma required 2+ years experience in healthcare reimbursement/collections required Intermediate proficiency in Internet and MS Office environments (Word, PowerPoint, Access, Excel, and Outlook) and the ability and desire to advance technically required