The Processing Officer Evaluate more complex data entry, clerical, and accounting tasks involved in the preparation and processing of patient insurance claims. Supervises releasing team with regards to productivity and efficiency.
Claims Management Department
Ensures that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment
Ensures that provider’s fees and service items charges coincide with their existing contract price list with Nextcare
Ensures the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing
Compares data on claims applications
Screens claim documents and processes claim adjustment
Ensures Payment Orders are properly created and forwarded accordingly for final documentation and filing
Ensures adaptability in various work-related tasks to be able to facilitate a multi-tasking role
Ensures that a high-quality standard of work performance is achieved at all times
Stands as a reference person for information on inquiries concerning claims processing procedures
Monitors correct application of beneficiary share accordingly on service items billed
Makes sure that claims are properly audited of all data entered with accurate medical claims details
Notes all discrepancies during the course of the system process are properly forwards and notifies immediate supervisors
Provide requisition of office supplies for Individual and Team requirements
Researches claims as needed
Obtains and audits medical records to compute and record patient charges
Performs other related duties incidental to the work described herein
Bachelor’s Degree: in Science or Veterinary medicine
2+ years filing/documentation experience. Experience within the Health Care Industry, TPA’s, insurance companies, Hospitals, Medical Centers is a plus
Attention to detail and ability to multi-task
Organizational & time management skills
Excellent team player
Ability to meet tight deadlines
Ability to work under pressure to tight deadlines
Strong communication skills
Ability to work well with all levels of internal management and staff, as well as outside clients and users
Ability to demonstrate sound work ethics
Show flexibility with excellent interpersonal skills
Flexible to work in shifting schedule
Demonstrate commitment to produce output base results
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