What are the responsibilities and job description for the Medicare Appeal position at COMTEC INFORMATION SYSTEMS?
Position: Medical Appeals Representative
Location: 5525 Reitz Blvd Baton Rouge, LA - 70809
Duration: 6 Months
- Job Profile Summary - Position will work onsite at the BCBS Client- LA Corporate office for the first few months and then will shift to a hybrid working remoted and onsite.
Job Description
NATURE AND SCOPE
- This role does not manage people
- This role reports to this job: SUPERVISOR, MEDICAL APPEALS
- Necessary Contacts: n order to effectively fulfill this position, the incumbent must be in contact with various internal and external entities including but not limited to, Appeals and Grievances, Customer Service, Member Services, Provider Network Administration, Provider Services, Correspondence, Legal, Medical Management, Marketing and Accounts Payable.
QUALIFICATIONS
Education
- High School Diploma or equivalent is required
Work Experience
- Experience with Facets is PREFERRED not required.: “3 years of insurance experience which includes benefits and claims research is required. Knowledge of Facets application highly preferred”
- 2 years of experience in a customer service and/or claims processing environment is required
- Experience can run concurrently.
Skills and Abilities
- Must be able to read and interpret health benefits for all lines of business.
- Requires thorough knowledge of the claims process and adjustment procedures.
- Must be familiar with CPT, ICD10 and HCPCS coding systems.
- Must have knowledge and understanding of accreditation guidelines, state laws, and internal claims systems.
- Advanced knowledge of Microsoft Office applications Word, Excel, etc. are required.
- Strong organizational and prioritization skills are needed.
- Requires attention to detail and strong record-keeping skills.
- Demonstrated ability to work in a rapidly paced and ever-changing environment is required.
- Facets and JIVA software proficiency is preferred.
- Knowledge of Adobe Reader, Zip File Manager, ESI, PA Hub, Provider Portal and related department software preferred
- Requires proficiency in scanning, printing, faxing capabilities
Job Type: Contract
Pay: $18.00 - $20.00 per hour
Expected hours: 40 per week
Schedule:
- 8 hour shift
Experience:
- Claims: 2 years (Required)
- Benefits: 2 years (Required)
- Insurance: 3 years (Required)
Ability to Commute:
- Baton Rouge, LA 70809 (Required)
Ability to Relocate:
- Baton Rouge, LA 70809: Relocate before starting work (Required)
Work Location: In person
Salary : $18 - $20
