Administrative Coordinator - Schertz, United States - ProPeer

ProPeer Schertz, United States

3 weeks ago

Description

Job Description

Job DescriptionDescription:

Job Summary

A ProPeer Independent Dispute Resolution (IDRE) Coordinator is an administrative position within our federal dispute resolution program. The role of the IDRE is to process the workflow of ERISA payment disputes between payor and provider. This position requires heavy attention to detail, data entry, and a high level of critical thinking. The position is electronically task driven within the workflow process and involves no external communication outside of the organization.

Requirements:

Essential Job Functions

General responsibility for processing administrative components of IDRE workflow process
Receives and coordinates dispute referrals through data entry into our portal workflow system
Downloading and processing of clinical and administrative documentation pertaining to the dispute
Notating disputes within the portal regarding components of the workflow process
Verifying and processing disputes for Conflict of Interest
Validating eligibility of the dispute within the federally based ERISA program
Requesting fees for the dispute process from the initiating and non-initiating parties
Processing fees received assigning to clinical dispute reviewer
Submitting final payment determinations to all parties through auto generated emails
Meeting daily production requirements for assigned segment of workflow
- COI/Eligibility/Request Fees: 65 disputes daily
- Receiving fees/downloading NOOF/assignment to clinical reviewer: 65 disputes daily
- Submitting closure letters to all parties based on outcome: 65 disputes daily
Conducts research driven projects surrounding cases of issue in coordination with IDRE Director
Utilizes critical thinking to determine outlier processes in conjunction with the rules of the program
Ensures compliance processes and procedures are adhered to for all federal requirements
Communicates with IDRE Director regarding any disputes outside of standardized process
Ensures seamless transition of all incoming disputes into the portal in a time sensitive manner
Ability to work via web-based portal applications
Ability to be resourceful and proactive in dealing with issues that may arise by working with team and IDRE Director
Support others in a team environment

· Assumes other activities and responsibilities from time to time as directed

Knowledge and Abilities Requirements

Ability to use Microsoft products (Word, Excel, PowerPoint, Outlook)
Basic office equipment experience preferred (copier, fax, shipping and receiving tools)
Written and verbal communication skills with a demonstrated ability to deliver excellent customer service
Ability to multi-task and quickly adapt in a fast-paced environment
Strong organizational skills
Attention to detail
Professional appearance
General Typing Skills at 65wpm
Data Entry 10 Key Skills at 5,000kph / Data Entry Alpha Numeric Skills at 10,000kph
Proficiency in English
Exemplary planning and time management skills
Ability to work in high pressure, deadline driven environment
Ability to multitask and prioritize daily workload
High level verbal and written communications skills
Critical Thinking Skills

· Demonstrated ability to problem solve complex, multifaceted, situations

· Ability to engage easily in abstract thought

· Strong organizational and task prioritization skills

Education and Experience:

High School Diploma or equivalent
3-5 years experience in an office based professional setting

License and Certification: N/A

Driving Essential: No

Position Demands:

This position requires sitting, bending, stooping for up to 8 hours per day in an office setting. Ability to lift and move objects weighing up to 20 lbs. Ability to learn technical material. The person in this position needs to occasionally move about inside the office to access file cabinets, office machinery, etc. Must be able to operate a computer and other office productivity machinery such as a calculator, copy machine, printer, etc. The person in this position frequently communicates with guests, employees, and vendors and must be able to exchange accurate information.

Disclaimer: The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of our personnel. All ProPeer employees and temporary team members may be required to perform duties outside of their normal responsibilities from time to time, as needed.

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