Job Summary:
The Senior Claims Processor & Trainer is responsible for assisting the Revenue Cycle Supervisor in overseeing the day-to-day operation activities for the Greenway team in addition to completing daily tasks as assigned. The individual will research, resolve, and process claims timely and accurately within the standard metrics. The lead will provide ongoing subject matter support and training to all existing and new team members. The lead is also responsible for maintaining accurate and up-to-date SOP documents.
Supervisory Responsibilities:
This position has no direct supervisory responsibilities.
Duties/Responsibilities:
- Assist RCM (Revenue Cycle Management) Supervisor in providing guidance, training, and instruction to the Devoted team.
- Assist the RCM supervisor in orienting new hires, providing training, and subject matter mentorship to the team.
- For the assigned production target, the transactions may involve working on paper claims, IB, enrollment forms (during and after AEP) and utilization management functions.
- Partner with other departments to resolve queries.
- Answer questions and resolve issues for consumer and clients timely and accurately.
- Develop, Maintain, Utilize, and follow Policies and Procedures daily.
- Work together with the team to produce process improvements.
- Lead in-job training sessions to improve employee performance.
- Apply knowledge/skills to operational transactional activities.
- Function as a technical resource to others in own function.
- Solves complex problems on own; proactively identifies innovative solutions to problems.
- Plans, prioritizes, organizes, and completes work to meet established objectives.
- Assist supervisor as a facilitator to resolve operational issues on the team.
- Share information across team members to increase overall team knowledge of concepts and to ensure consistent application.
- Attend in person onsite meetings as required, based on business need (coaching, training etc).
- Perform other related duties as assigned.
Required Skills/Abilities:
- Strong analytical skills, including the ability to catch data that represents inaccurate/incomplete from the actuals.
- Typing skills and accuracy in keying data required.
- Extensive knowledge of medical terminology with the ability to correctly read and assess medical documents.
- Basic cognitive skills that include language, math, and reasoning ability.
- Strong interpersonal skills
- Decision-Making Skills
- Excellent verbal and written communication skills
- Exceptional problem solving and solution driven skills with the ability to review problem, troubleshoot root cause issues and determine path to resolution.
- Strong attention to detail to handle the complex claims.
- Ability to work effectively in a changing environment and be able to contribute innovative ideas.
- Excellent time management and organizational skills balancing multiple priorities.
- Self-starter, able to independently drive work.
Education and Experience:
- At least 2 years of experience in processing healthcare claims
- High school diploma or equivalent
Physical Requirements:
- Prolonged periods of sitting at a desk and working on a computer.
Job Type: Full-time
Pay: $19.00 - $25.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
- Call center
- In-person
- Office
Experience:
- Medical billing: 3 years (Preferred)
- Customer service: 3 years (Preferred)
- Training & development: 3 years (Required)
Ability to Commute:
- Addison, TX 75001 (Required)
Ability to Relocate:
- Addison, TX 75001: Relocate before starting work (Required)
Work Location: In person