Claims Team Lead

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. 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.