Description
Provide for ensuring accuracy of electronically transmitted data for the purpose of releasing batch claims held for review.
This position is 90% remote but travel to the office will be required for meetings, training, and other department needs.
Responsibilities:
- Update data into the Amisys system accurately and efficiently.
- Verify and correct as necessary claims received through the FormWorks process to include but not be limited to - Individual characters and fields in OCRepair and OCRepCrit, Information contained in KE (Key Entry).
- Complete UB's and HCFA's in FormWorks for claims unable to process directly via OCR (KFI/Key From Image).
- Notify the supervisor and/or team leader of any issues that my compromise client satisfaction.
- Verify electronically received data pre-adjudication.
- Investigate via Filenet software or EDI (Electronic Data Interchange) Inquiry Screen(s) any flagged claims.
- Claim hold/Batch error correction
- Search continuously for improvement opportunities and notifies the supervisor and/or team leader of trends.
- Maintain a thorough working knowledge of processes for electronically received data;
Qualifications
- Completion of High school diploma or equivalent.
- Able to use a QWERTY keyboard;
- Knowledge of Insurance, Managed Care, or Benefits Administration environment preferred;
- Prefer competency in MS Office and PC skills.
- Able to demonstrate organizational, interpersonal, and communication skills.
- Maintain designated production and quality standards required.
- Previous mailroom experience is preferred.
Licensure, Certifications, and Clearances:
UPMC is an Equal Opportunity Employer/Disability/Veteran
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