What are the responsibilities and job description for the Worker Compensation Claims Assistant position at Optimal Inc.?
Position Description:
- Responsible for entering medical and miscellaneous invoices into the MBP (Medical Bill Payment) system in a timely manner.
Skills Required:
- Data entry of medical and miscellaneous invoices into Medical Bill Payment and Miscellaneous Expense Payment ledgers, including expedited or special handling requests, for a multi-jurisdictional claim process.
- Proof and balance bill batches and transmit them to the Bill Processing Supervisor and/or Bill Reviewer for evaluation.
- Complete preliminary and final edit process to pay or deny bills as indicated by the Workers' Compensation Plant Representative.
- Communicate with vendors and Workers' Compensation Plant Representatives to resolve technical payment issues in a multi-jurisdictional claim system.
- Prepare non-PBM pharmacy bills and mail to PBM for repricing.
- Provide back-up customer service telephone activities.
- Mail EOBs.
- Support high-volume mail room functions.
- Collaborate with team members to resolve billing inconsistencies and errors.
- Translate codes on medical invoices.
- Perform in-depth analysis of medical invoices for proper documentation and correct calculations.
- Excellent oral and written communication skills.
- Proficient 10 Key Data Entry.
- Excellent personal computer skills, such as Word, Excel and Outlook.
- Ability to work in a team environment.
- Proven experience as a billing specialist.
- Comfortable dealing with numbers and processing financial information.
- High degree of attention to detail and trustworthiness.
Experience Required:
- 2-3 years of data entry in Workers' Compensation or medical field.
Education Required:
- High School diploma or equivalent.
