Flex claims processor II
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POST DATE 8/10/2018
END DATE 9/7/2018
JOB DESCRIPTIONThe Flex Claims Processor is responsible for verifying and processing transportation provider billing invoice forms in an accurate and timely manner. In addition, the Flex Claims Processor will work as a Customer Service Representative for eight hours each week, usually on Mondays. The allocation of hours between Claims Processing and CSR tasks will be determined by management and may vary. The Flex Claims Processor will be required to meet both claims and CSR production standards.
ESSENTIAL FUNCTIONS AND REQUIREMENTS
* Process transportation provider billing invoice forms at a rate of 180 manual claims per hour or 540 Web Billing/Electronic claims per hour with a 98% minimum quality score. This is a 10% increase over the expectation of a Claims Processor. The standard for earning any incentive payment is 105% of the required production. The incentive program may be discontinued or changed at any time.
* Work for 8 hours taking reservations. Focused on peak call-volume days, the Flex Claims Processor will be expected to be available every Monday. As such, the Flex Claims Processor can have no more than two attendance occurrences on Mondays in a calendar year. Attendance occurrences on Mondays will count double the normal policy, i.e. two occurrences for an absence and one occurrence for lateness . Time off is permitted on Mondays only if it is prescheduled and approved in advance by management.
* Production standards while taking member reservations will be monitored by the supported call center and the Flex Claims Processor will be required to take calls at a rate of 90% of the standard applicable to full-time CSRs working the same contract(s). Allowances will be made for unexpected lulls in overall phone volume. The Flex Claims Processor will also be required to pass all call quality monitoring.
* Up to twice a year, the Flex Claims Processor must attend a call reservation training course to be held outside normal business hours. This will be scheduled at least two weeks in advance, and the Flex Claims Processor will be paid for the time spent attending the training in accordance with LogistiCare and applicable law.
* Process transportation provider billing invoice forms
* Communicate with transportation providers when applicable
* Identify and resolve problems with transportation provider billing invoice forms
* Meet all departmental deadlines
* Work closely with the Fraud and Abuse department
* Adhere to and ensures all company policies and procedures are maintained
* Performs other administrative duties as assigneD
* Competency Statement(s)
* Accurate - Ability to perform work accurately and thoroughly
* Communication, Oral - Ability to communicate effectively with others using the spoken word
* Communication, Written - Ability to communicate in writing clearly and concisely
* Customer Oriented - Ability to take care of the customers' needs while following company procedures
* Interpersonal - Ability to get along well with a variety of personalities and individuals
* Problem Solving - Ability to find a solution for or to deal proactively with work-related problems
* Time Management - Ability to utilize the available time to organize and complete work within given deadlinesEducation
* High School Graduate or General Education Degree (GED)Experience
* Previous experience in data processing preferredSKILLS & ABILITIES
* 10-key skills required
* Superior customer service and phone skills
* Must be able to work independently or with a team as well as work various shifts
* Ability to quickly learn new technology
* Must be able to understand and follow complex instructions
* Ability to accurately type 35wpm*CB*
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled