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.
LOCATION: On-Site in the District of Columbia
ESSENTIAL FUNCTIONS
* Correlate the reimbursement request forms and resubmissions by provider per day in chronological order.
* Approvals and denial for reimbursement and resubmissions.
* Data entry.
* 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.
* Computer experience.
* Following training, able to adequately implement concepts of Route Logic.
* Able to lift and/or move items up to 25 pounds.
* Must be able to key 8000+ keystrokes.
QUALIFICATION
* High School diploma.