Claims Team Lead

Southeastrans, Inc.; Villa Rica (GA); Hybrid; USD 30,000 - 42,000; Full time

Job summary

Southeastrans, Inc. in Villa Rica, GA seeks an Admin Support Worker to support the Claims Team, focusing on reconciliation of reimbursement request forms, filing, and processing provider submissions.

The role requires excellent communication skills, the ability to work in a busy environment, and knowledge of reimbursement policies. Medicaid Non-Emergency Transportation familiarity is preferred. Additional duties may be assigned.

Qualifications

• Excellent oral and written communication skills.
• Ability to work in a busy environment and manage multiple tasks.
• Knowledge of reimbursement policies and procedures.
• Familiarity with Medicaid Non-Emergency Transports preferred.
• Must be able to lift and move up to 25 pounds.
• Ability to follow instructions from management.

Responsibilities

• Correlate reimbursement forms and resubmissions by provider daily.
• Approve or deny reimbursement requests and resubmissions.
• Distribute copies of denied reimbursement requests to providers.
• File all reimbursement forms.
• Assist with special rates from the call center.
• Relay instructions and information from management.
• Maintain knowledge of company policies and procedures.
• Update management on changes affecting the company.
• Other duties as assigned by management.

Skills

Communication

Multitasking

Stress management

Reconciliation

Customer service

Medicaid NEMT knowledge

Route Logic

Lifting 25 lbs

Job description

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.

Admin Support Worker Villa Rica, GA, US

30+ days ago Requisition ID: 2467

SUMMARY:

The Claims Team Lead is responsible for the reconciliation of the provider’s reimbursement request forms. In addition, he/she will be responsible for maintaining all departmental filing and other duties that may be assigned.

ESSENTIAL FUNCTIONS

• Correlate the reimbursement request forms and resubmissions by provider per day in chronological order.


• Approvals and denial for reimbursement and resubmissions.


• Responsible for generating and distributing copies of denied reimbursement requests to providers.


• Filing all reimbursement forms.


• Assisting with special rates from the call center.


• Relays instructions, messages and other information as requested from the management team.


• Maintains 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.


• Other duties as assigned by management team.

REQUIRED SKILLS AND ABILITIES

• Excellent communications skills oral and written.


• Able to work in a busy environment.


• Able to function effectively in stressful situations.


• Knowledge of reconciliation and customer service policies and procedures.


• Knowledge of Medicaid Non-Emergency Transports preferred.


• Able to handle multiple tasks simultaneously.


• Following training, able to adequately implement concepts of Route Logic.


• Able to lift and/or move items up to 25 pounds.