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Claims Support Assistant

Company: EBMS
Location: Billings
Posted on: January 12, 2022

Job Description:

EBMS is currently seeking a Claims Support Assistant to join the team! This position compiles and maintains claims data and supports the Claims Department while actively participating in service and quality assurance initiatives. The Assistant maintains a comprehensive understanding of the plan document(s) under their scope of responsibility.
Responsibilities include but are not limited to:Claims Support

  • Contacts medical providers for information needed to complete claims processing.
  • Manages refund requests by managing refund database, following up with providers and members on refund requests, and follows-up with appropriate parties as necessary.
  • Manages and monitors HIPAA authorization requests.
  • Runs daily reports functions.
  • Manages and pays fees for outside repricing vendorsAdministrative
    • Maintains filing on and off site
    • Sorts and distributes daily correspondence
    • Prepares all outgoing mail for Claims Department
    • Enters data into pertinent computer systemsCustomer Service
      • Acts as a role model in demonstrating the core values in customer service delivery
      • Provides timely and thorough follow up with, internal and external customers
      • Appropriately escalates difficult issues up the chain of command
      • Trains new employees as assignedQuality Assurance
        • Serves on committees, work groups, and/or process improvement teams, as assigned, to assist in improving quality/customer satisfaction.
        • Recognizes and alerts appropriate supervisor of trends within their scope of responsibility that fall outside of quality parameters.
        • Performs self quality monitoring in order to develop and execute plans to meet established goals.
        • Provides ongoing feedback to help optimize quality performance.
        • Collaborates with others and cross-departmentally to improve or streamline procedures.
        • Develops new or improves current internal processes to improve quality
          Required Experience / Education:
          • High school diploma or GED
          • 1+ year within clerical or customer service role
          • Working knowledge of computers and software including but not limited to Microsoft Office products
          • Demonstrated organizational skills, problem-solving, analytical skills and detail oriented
          • Strong written, oral and telephonic communication skills
          • Demonstrated ability to work independently, prioritize workloads multi-task and manage priorities in order to meet deadlines

            Want to see our latest job opportunities? Check out our website:
            EBMS is an industry leader in health risk management and third-party administration of self-funded health plans, nationwide. Our strategies are transforming the health and well-being of individuals and organizations.
            EBMS, LLC is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

Keywords: EBMS, Billings , Claims Support Assistant, Other , Billings, Montana

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