The Repricing Specialist I is responsible for re-pricing medical (CMS1500, UB04) and dental claims using multiple applications to obtain discounted rates.
ESSENTIAL FUNCTIONS
Complete repricing of CMS1500 and UB04 forms for various PPO networks
Ability to use multiple computer applications to obtain the information needed to correctly re-price a claim
Accurately key claims once repriced into the QicLink system
Communicate effectively with various departments to resolve challenges
Maintain a minimum of 99% accuracy in relation to the re-pricing and keying of claims
Assist in training team members on existing workflow updates/changes
Drive resolution of escalated issues/call notes/appeals/emails
Assist with remediation of escalated DocuVantage Issues (EDI)
Assist with Product Implementation - Client specific requests/workflows/contracts/projects
Maintain regular and reliable attendance
Perform other duties and responsibilities as assigned
EDUCATION
High School Diploma, GED or equivalent work experience required
EXPERIENCE & SKILLS
Experience with HCFA and UB92's, required
Proficiency in Microsoft Word, Excel, Outlook and Access preferred
Ability to key a minimum of 10,000 keystrokes per hour
COMPETENCIES
Communication
Customer Focus
Accountability
Functional/Technical Job Skills
PHYSICAL DEMANDS
This is a standard desk role - long periods of sitting and working on a computer are required.
WORK ENVIRONMENT
Remote
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.