Medical Claims Specialist Jobs Vacancy in Hms Holdings Albany
Hms Holdings Albany urgently required following position for Medical Claims Specialist. Please read this job advertisement carefully before apply. There are some qualifications, experience and skills requirement that the employers require. Does your career history fit these requirements? Ensure you understand the role you are applying for and that it is suited to your skills and qualifications.
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Medical Claims Specialist Jobs Vacancy in Hms Holdings Albany Jobs Details:
HMS makes the healthcare system work better for everyone. We fight fraud, waste, and abuse so people have access to healthcare—now and in the future. Using innovative technology and powerful data analytics, we help government and commercial payers reduce costs, increase quality, and achieve regulatory compliance. We also help consumers take a more active role in their own health. Each year, we save our clients billions of dollars while helping people live healthier lives. At HMS, you will develop new skills and build your career in a dynamic industry while making a difference in the lives of others.
We are seeking a talented individual for a Provider Relations Representative IIwho is responsible for interfacing with Physician/Provider population to recover payment on behalf of HMS clients. Also responsible for support function activities (i.e. documenting, refund support, linking). Ensure production and quality standards are met.
- Initiates phone calls with customer’s (providers/pharmacies/patients/carriers etc.), and answers incoming communication to customers, confirms receipt of mailing and answers inquires.
- Provides timely response and resolution for all provider initiated inquires (phone calls, emails or faxes).
- Reviews and analyzes documentation and claims data to determine validity and proper action.
- Updates accounts receivable system with denial and group information.
- Assists with high priority special projects.
- Participates in support function activities including documentation, refund support, and/or linking).
- Performs other functions as assigned
Knowledge, Skills and Abilities:
- Ability to work proficiently with Microsoft Word.
- Ability to multi-task and prioritize.
- Ability to be careful and thorough about detail.
- Ability to organize well.
- Ability to demonstrate a customer service orientation.
Work Conditions and Physical Demands:
- Primarily sedentary work in a general office environment
- Ability to communicate and exchange information
- Ability to comprehend and interpret documents and data
- Requires occasional standing, walking, lifting, and moving objects (up to 10 lbs.)
- Requires manual dexterity to use computer, telephone and peripherals
- May be required to work extended hours for special business needs
- May be required to travel at least 10% of time based on business needs
- High School Diploma or GED required
Minimum Related Work Experience:
- 3+ years’ experience as an examiner/processor with exposure to medical terminology and claim processing experience in Commercial Insurance or Government Programs required
- 3+ years previous experience in a claims customer service environment OR
- 3+ years of answering inbound calls regarding claims processing
- Previous experience as an examiner/processor in an audit recovery area preferred
Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
Job Type: Full-time
- Albany, NY (Required)