Knowledge of Product Lines - PPO and HMO to include Medicare, Medical, Commercial plans
Need to understand how to read professional and facility claims
Understanding of different billing codes
Excel
MS Office
Day To Day Responsibilities Of Role
Process inquiries from claims to determine if the billed serices from the provider requires an authorization, has an authorization or has to be reviewed by clinical
A lot of departments come to this area to research what happened with the processing of the authorization claim - Must have attention to detail and provide good customer servic
Performance Expectations
Meet a 95% production goal by the time ramp up period has passed
4-5 weeks of training
Seniority level
Not Applicable
Employment type
Full-time
Job function
Other
Industries
Mental Health Care, Wellness and Fitness Services, and Hospitals and Health Care
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