- Associates Degree/commensurate work experience
- Related work experience in Healthcare
- Software systems including Windows 2000, MS Office, IMAX(external Claims editing), Facets
- Knowledge of Word, Excel and ACCESS
- Ability to research to analyze provider information submitted on claims
- Identify and maps claims to the appropriate provider number for claims in the invalid provider queue.
- Ensures that work is completed according to the service level agreement.
- Coordinates the provider mailing for all claims in the invalid provider queue that could not be processed due to missing or invalid information.
- Responsible for working on projects assigned by Supervisor.
- Performs other related duties and projects as assigned.
- Adheres to KMHP policies and procedures.
- Supports and carries out the Mercy Mission & Values.
- Attends required training on an annual basis.
- Ability to enter/change provider information in Facets and meet the minimal accuracy standard.
- Meets turn-around time standard for Invalid Provider Queue claims identification and resolution.
- Demonstrates good customer service experience to both internal and external customers.
- Demonstrates flexibility and team support to ensure efficient, effective operations, which crosses all LOBs.
- Ability to respond to extreme needs such as backlogs and staff constraints by contributing above and beyond routine work effort and hours.
- Ability to work well with co-workers and create a positive work environment
- Demonstrates a willingness and aptitude to be cross-trained in other functions to ensure efficient operations during times of peak volume or low staffing.
