Claims Specialist

WPPA ProviDRs Care   Wichita, KS   Full-time     Other
Posted on September 11, 2020

Position Title: Claims Specialist

Reports To: Claims Manager 

Qualifications: 

  • Excellent written and oral communication skills 
  • Basic computer skills with exposure to Microsoft Office preferred 
  • Ability to organize and handle multiple tasks well 
  • Extraordinary attention to detail 
  • Good math skills 
  • Good time management skills 
  • Good customer service skills 

Position Requirements: 

  • Complete assigned duties accurately and in a timely manner 
  • Repricing error level is expected to be less than or equal to 1.00% 
  • Active participation (or facilitation when necessary) in meetings 
  • Provide adequate input and feedback 
  • Exude problem solving skills when required 
  • Maintain and display a positive and team‐oriented attitude 
  • Team engagement on a continual basis 
  • Continual courteous and professional behavior 
  • Comply with all guidelines set forth by ProviDRs Care 
  • Maintain a professional phone etiquette 
  • Adhere to HIPAA compliance requirements 

Responsibilities: 

  • Update eligibility records as assigned 
  • Complete assigned claims queues 
  • Complete Primary queue assignments within established TAT 
  • Complete Secondary queue assignments within established TAT 
  • Prepare reports as requested 
  • Analyze data/information as requested 
  • Work mail as assigned 
  • Open / Sort 
  • Pull out claims that require special handling instructions 
  • Scan 
  • Upload Files 
  • Prep & Mail out 
  • Answer telephone calls according to assigned schedule 
  • Provide customer service via telephone, email, facsimile, etc... as needed 
  • Complete assignments given by Claims Manager 
  • Cross training as assigned by Claims Manager 
  • Processing of Clearinghouse and Payer Rejects 
  • Perform entry level Quality Assurance as assigned