Posted on Aug. 4, 2016
MEMBER, ELIGIBILITY AND PROVIDER SERVICE POSITIONS - HEALTHCARE
* Thoroughly understand a health insurance environment and how software can be used to in increase efficiencies, cost effectiveness and quality care.
* Member/Provider Service and Maintenance to include Reporting and File Loading to the system
* Processing Medical Insurance Claims and Adjustments.
* Load and maintain provider, benefit or reference table information into computer system(s).
* Apply processes to research and resolve medical claim/encounter issues, pended claims and update system(s) as necessary.
* Apply knowledge of interfaces and other applications to research and resolve issues and update system(s) as necessary.
* Data Entry of required information as needed.
* Ability to handle fluctuating volumes of work and be able to prioritize work to meet deadline.
* Suggest improvement processes to ensure systems are working more efficiently and improve quality.
The office location for this position is 8162 Woodland Center Blvd, Tampa, FL 33614.
FIRSTSOURCE TRANSACTION SERVICES, LLC. IS AN EQUAL OPPORTUNITY EMPLOYER THAT DOES NOT DISCRIMINATE ON THE BASIS OF AGE (40 & OVER), RACE, COLOR, RELIGION, SEX, NATIONAL ORIGIN, PROTECTED VETERAN STATUS, DISABILITY, SEXUAL ORIENTATION, GENDER IDENTITY OR ANY OTHER PROTECTED CLASS IN ACCORDANCE WITH APPLICABLE LAWS.
* Expert level of knowledge in Microsoft applications
* Expert level of knowledge in medical terminology, ICD-9, CPT and HCPC
* Knowledge of LuminX and/or EbiX systems
* Knowledge of interface testing, data load validation and other data related tasks as assigned
* Ability to work independently as well as within a team
* Analytical and problem solving skills
* Deductive and inductive thinking
* Attention to detail and accuracy
* Ability to meet department standards of turnaround time and quality
* Demonstrate consistent multi-tasking skills and planning for prioritizing workload with focus on deadlines in multiple health plans.
* Utilize effective verbal and written communication skills for external and internal departmental relations
* Advanced verbal and written communication skills
* Ability to articulate complex configuration solutions
* Maintain regular attendance based on agreed-upon schedule
* Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)
* Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers
* Healthcare Insurance experience
* Health Claims or application vendor experience and provider maintenance requirements.
* Experience in medical coding initiatives and coding guidelines