Our client is an Overland Park based administrator of healthcare benefits. They are in need of a Claims Receipt Technician to join their team! This position is a contract to hire! M-F 8am-4pm with a 30min lunch, 37.5hr work week The Claims Receipt Technician will be responsible for supporting the claims adjudication staff by providing complete front-end entry and preparation of claims and other information required for adjudication. This includes performing manual charge data entry, review of EDI claim charge exceptions in the Oracle system, utilizing decision-making skills to correctly select and interpret the data resident on the charge to accurately reflect all the information required for adjudication; to perform manual data entry of provider information of claims, to resolve EDI provider exceptions; to perform the manual scanning and indexing of claim related documents into the Document Management System, both batch and single indexing; to provide clerical support functions relating to all mail functions in Offices Services. In addition, the position includes, but is not limited to, supporting the functions of switchboard/receptionist, making provider and group calls, prepping mail, resolving address issues, mailing assorted letters and packages, copying and faxing. Duties/Responsibilities
- Enter data obtained from all types of mail - hard copy claim forms, electronic claims, billings and correspondence into the appropriate computer system, according to departmental needs and requirements.
- Search and maintain provider information obtained from manual entry of claims forms or from EDI transmissions of claims in the applicable computer system according to departmental needs and requirements.
- Perform manual or web-based repricing functions, which includes the verification of provider participation applying the appropriate reimbursement schedule and determining the correct discount amount if applicable.
- Perform clerical functions, including but not limited to: o Picking up and distributing daily reports. o Opening, prepping, sorting, batching and date stamping claims mail. o Sorting, folding, and stuffing system generated letters as needed. o Retrieving authorizations and matching to the appropriate letters and faxing to the medical records retrieval vendor.
- Perform file room related functions to includes, but not limited to: o Picking up files/documents from Claims Analysts, Healthcare Management, Customer Service, QA and Training and distributing to designated area.
o Preparing out-going mail. o Pulling files and documents per request received manually, via File Request or Contact Management. o Searching for misplaced files. o Sorting mail as needed. o Copying files and other documents as required.