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JOB DESCRIPTION OVERVIEW:
This position is responsible for reviewing carrier denials from Medicaid, Medicare, Blue Cross Blue Shield, Managed Care, and Commercial Insurances. Maintains accuracy and production to ensure remittances are being processed effectively and appeals are resolved through payment.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
QUALIFICATIONS / EXPERIENCE:
SUPERVISORY RESPONSIBILITIES:
PHYSICAL / ENVIRONMENTAL DEMANDS:
This job should be performed in a well-lighted and well-vented environment. Requires constant sitting tolerance. Extended amount of time spent in front of computer display terminal.
This position may require manual dexterity and/or frequent use of the computer, telephone, 10-key, calculator, office machines (copier, scanner, fax) and/or the ability to perform repetitive motions and/or meet production and quality standards to comply with the essential functions. Also, may require physical and/or mental stamina to work overtime, additional hours beyond a regular schedule and/or more than five days per week.
DISCLAIMER:
Cooperative, positive, courteous and professional behavior and conduct is an essential function of every position. All employees must be able to work with others beyond giving and receiving instructions. This includes getting along with co-workers, peers and management without exhibiting behavior extremes. Job functions may require personal leadership skills such as conflict resolution, negotiating, instructing, persuading, speaking with others as well as responding appropriately to job performance feedback from the supervisor. Additionally, the information contained in this job description has been designated to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this position.