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Repricing Specialist I
Chicago, IL
Job Description
REPRICING SPECIALIST I
POSITION SUMMARY
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.
Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
High School or Equivalent
Required Experience
Open
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