Job Location : Mechanicsburg,PA, USA
Are you interested in joining a team of experienced healthcare experts and have the ability to shape and transform the healthcare delivery system? At our family of companies, everything we do is to help improve the lives of the nearly 12 million Medicare beneficiaries we serve and 700,000 health care providers who care for them. It is our goal to help create a better health experience for all consumers. Join our winning culture and help transform Medicare for the millions of people who rely on its services.
Benefits info: * Medical, dental, vision, life and supplemental insurance plans effective the first day of the month following date of hire * Short- and long-term disability benefits * 401(k) plan with company match and immediate vesting * Free telehealth benefits * Free gym memberships * Employee Incentive Plan * Employee Assistance Program * Rewards and Recognition Programs * Paid Time Off and Paid Sick Leave
SUMMARY STATEMENT This position is responsible for initial screening, review, and imaging of all incoming Medicare documents to determine the nature of each claim, inquiry, or check and ensure they are controlled appropriately. The incumbent prepares the work for imaging and directs the work to the appropriate workflow system via OCR (Optical Character Recognition) or manual data entry. The incumbent is expected to meet quality and production standards established by Management.
ESSENTIAL DUTIES & RESPONSIBILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.
* Sort and read each document received in the company. Additional research may be required using the appropriate Medicare System to help determine the document type. (20%) * Perform routine clerical support for functional groups in accordance with standard procedures, such as copying; preparing and distributing mail, inventory, data entry; filing, faxing and retrieving documents, indexing and scanning/imaging. Online processing system(s) may be used to perform one or more of these clerical functions. (20%) * Review scanned and electronically submitted documents in OCR. This includes checking the document's date of receipt, classifying the pages appropriately, and the data entry/research portion of reviewing each classified page. (15%) * Prepare Provider Enrollment applications and documentation for credentialing by reviewing for unprocessable criteria and returning those that do not meet that criterion. This includes dispositioning returns in the appropriate workflow system and preparing all work for imaging as indicated by the work type. (10%) * Sort and prepare all priority, specialty, reprocessed, and/or aged requests or documents received internally from other Medicare and Novitas departments. This involves creating and/or printing an email request from Outlook, sorting each case/request by type and receive date, and physically preparing each case for imaging. (10%) * Open, sort, and research undeliverable mail for imaging and/or distribution. (5%) * Identify quality-related problems and notifies management when quality is being compromised. Recommend process improvements designed to improve accuracy, timeliness of processing, and/or eliminate manual effort required. (5%) * Assist with mailing out Medicare documents and letters to the appropriate external location. This includes metering all external mailings or sending out via priority/certified mailings. (5%) * Record daily processing times and totals to manage inventory. (5%) * Prepare Medicare documents for confidential destruction or permanent storage. (5%)
Performs other duties as the supervisor may, from time to time, deem necessary.
REQUIRED QUALIFICATIONS * High School Diploma or GED * Basic level computer skills, which include the following: * Ability to navigate using a browser * Ability to create a bookmark/favorite * Ability to locate web addresses * Ability to send/receive/reply to email * Ability to understand menu bars * Ability to use basic edit features such as cut, copy and paste * Ability to enter data into a spreadsheet * Demonstrated organization skills; demonstrated clerical aptitude * Ability to perform any of the required duties as dictated by incoming mail volumes * Demonstrated reading and comprehension skills * Ability to work in a team-oriented department, interact and problem solve with internal customers
PREFERRED QUALIFICATIONS * One year experience in a business environment
The Federal Government and the Centers for Medicare & Medicaid Services (CMS) may require applicants to have lived in the United States for a minimum of three (3) years out of the last five (5) years to be employed with the Company. These years of residence do not have to be consecutive.
We are an Equal Opportunity Employer/Protected Veteran/Disabled