Contract

EXPECTED WORK AND PERFORMANCE

This section is intended to provide a more detailed overview of what the expectations of the job are to include: work to be performed, expected performance results and how they will be measured, as well as connection to corporate goals, values, and mission. Job duties and responsibilities include the following. Other duties may be assigned as needed.

• Accountable for administrative support duties to include, but not limited to, data entry, scanning of claims, processing and claims payment processing, maintain claim records, reporting, and researching claim information.
• Open incoming mail and process it based on department policy.
• Scan and fax claim from incoming mail to our mailroom vendor.
• Processes returned mail and process it based on department policy.
• Organize and direct refund checks received via incoming to the appropriate team members to process.
• Prepares outgoing mail to ensure timely delivery to members and providers.
• Complete W-9 updates to ensure the correct information for provider name and address updates in the claims processing system.
• Assist with completing requests for copies of EOB/EOPs sent to members and providers.
• Supports all department initiatives in improving overall efficiency.
• Actively support other team members and provide resources to enable them to achieve all team goals.
• Conduct other ad hoc tasks as required and assigned, including, but not limited to, special projects.

QUALIFICATIONS

This section captures the education, experience, work experience, and specific knowledge requirements for the role.

Required

• High school diploma.
• Computer skills and experience with MS Applications – Adobe, Excel, Word, Outlook.

SKILLS

This section captures the job competencies and soft skills needed to perform the expected work and performance for the role.

• Extremely organized with the ability to effectively manage multiple tasks.
• Initiative-taking and the ability to work independently with minimal supervision.
• Aptitude to work in a deadline driven environment.
• Ability to communicate clearly, orally and in writing, with the ability to effectively interact with internal and external contacts.
• Strong work ethic and ability to adapt to new directions as business plans evolve.
• Must be willing to go onsite Monday through Friday in our Frisco, TX office.

PHYSICAL REQUIREMENTS

Work is performed in an office environment and requires the ability to operate standard office equipment and keyboards. Must have the ability to walk short distances.

Required to stand, walk, and sit; talk or hear, both in person and by telephone; use hands to finger, handle or feel objects or controls; reach with hands and arms. Regularly required to stoop, kneel, bend, crouch and lift up to 25 pounds. Specific vision abilities required by this job include close vision, distance vision, depth perception, color vision and the ability to adjust focus.