Claims Specialist I

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process. Claims Specialist I Admin Support Worker Villa Rica, GA, US SUMMARY: Responsible for the reconciliation of provider’s reimbursement request forms and maintaining all departmental filing. This role is also charged with communicating with the provider the proper process of filing claims as well as denial of claims. Responsibilities Correlate the reimbursement request forms and resubmissions by provider per day in chronological order. Approve and deny claims for reimbursement and resubmissions. Generate and distribute copies of denied reimbursement requests to providers. File all reimbursement forms. Assist with special rates from the Call Center. Relay instructions, messages and other information as requested from the management team. Maintain a current working knowledge of all company policies, procedures, rules, regulations and memorandums. Responsible and accountable for updating management on changes and/or extraordinary circumstances affecting the company and/or transportation provider. Perform other duties as assigned by the management team. Required Skills and Abilities Excellent oral and written communication skills. Ability to work in a busy environment. Ability to function effectively in stressful situations. Knowledge of reconciliation and customer service policies and procedures. Knowledge of Medicaid Non-Emergency Transports preferred. Ability to handle multiple tasks simultaneously. Proficient in Microsoft Office suites (Word, Excel, PowerPoint). Following training, ability to adequately implement concepts of Route Logic. Ability to lift and/or move items up to 25 pounds. Data entry: Must be able to key 8000+ keystrokes. Qualifications High School diploma. 1-2 years of claims experience. 2-3 years of customer service experience. #J-18808-Ljbffr