Data Validation Specialist

Data Validation Specialist

About Company

Samaritan Ministries is a Biblical solution to health care. It is not insurance. We deliver authentic,

compassionate, and personal service in the name of Christ to enable and inspire members to provide for one another’s medical needs through prayer, encouragement, and financial support.

From demonstrating Christ-centered compassion to modeling best practices in health care sharing, Samaritan Ministries is committed to keeping Jesus at the center of everything we do. The way we interact with our colleagues and engage with our members is a testament that we are ultimately serving Christ and His Kingdom.

Summary

To serve the members of REDEEM Healthshare by providing accurate and efficient entering of data sent in by members.

Competencies

• Attention to Detail
• Analytical Thinking
• Digital Literacy
• Information Gathering and Processing
• Acting with Integrity, Empathy, and Compassion
• Collaborating with Others
• Neighbor Focus
• Pursuing Excellence
• Decision Making
• Data Governance and Compliance
• Improving Business Processes
• Quality Focus

Key Responsibilities

• This is an Onsite position in Dallas, TX
• Act as the primary reception point and directory for all non-EDI bills, member health documentation, and bill-related tasks.
• Validate standard, non-standard bills and Balanced bills, accurately confirming necessary itemizations, escalating problem bills to the proper team, updating and consolidating bill images.
• Determine if bill submission was completed correctly, verify data and enter it into system for adjudication
• Reject non-compliant bills. Reject bills identified as balance bills that are not true balance bills.
• Research and review assigned bills by navigating multiple systems and platforms and accurately capture the data/information necessary for processing (e.g. verifying pricing, prior authorizations, etc.)
• Prepare and maintain required records, files, and reports on billing and financial activities; and ensure compliance with REDEEM Guidelines.
• Manually enter bill data on Keyed Form Images (KFI).
• Attend meetings as required and Collaborate with team members, Team leaders and Managers to resolve bill problems, escalating when needed.
• Keep accurate records of member interactions, bill and document updates in all necessary software.
• Troubleshoot with vendors to resolve bill problems at various stages in the life cycle of a bill.
• Communicate directly with members for bill status updates and necessary actions to expedite lifting the spiritual and financial needs of our members.
• Manage all Health History Review Documentation to ensure proper receipt and update of all necessary member and provider documents required for completing a member’s health history.
• Maintain confidentiality of sensitive member information.
• Provide continual assessment and improvement of work processes.

Qualifications and Experience

• Must be able to work in-person in Dallas, TX
• High School Diploma or GED. (High school diploma)
• Staff are required to possess applicable knowledge to bring value to REDEEM in this role, know and utilize resources well, ask questions to ensure full understanding, gain and retain knowledge to keep up with changes, and accept and engage with training to grow knowledge for current and future responsibilities.
• Knowledge of internal policies and procedures
• Reading and interpreting medical bills
• Basic Math
• Knowledge of REDEEM Guidelines
• Strong work ethic and self-starter, able to adapt to change within a fast-paced environment, and learn and navigate new software quickly.
• A compassionate and professional attitude with an ability to quickly develop a rapport and trust with members and maintain confidentiality.
• Willingness to grow in skills, knowledge and capability, in line with goals agreed upon with supervisor.
• Maintains a humble, Christ-centered, and others-focused ‘team player’ attitude.

Additional Information

• Tasks are normally conducted in a regular office environment, requiring use of computer and mouse and other standard office equipment. Staff usually remain in a stationary position, often standing or sitting for prolonged periods.
• Staff will observe safety principles while performing the duties of the position.
• Staff are expected to have reliable transportation to work.
• May need to lift and move items up to 35 lbs on occasion.
• Disclaimer: This job description is intended to describe the general nature and level of work being performed by people assigned to this job. They are not intended to be an exhaustive list of responsibilities, duties and skills required of personnel in the classification. Work hours may be irregular including performing duties on evenings or weekends.
• This position requires an active commitment to the mission and values of SMI. In the course of performing job duties, the employee will act in a manner that is Christ-honoring as well as Christ-like, demonstrating a personal Christian faith and witness in all interpersonal interactions.

Pay Range: $16.25 - $21.80/hr Starting pay usually falls within the lower half of the pay range and is determined by experience, skills, and education.​

Benefits Include:​

• Performance-based incentive pay​
• SMI Membership with monthly healthcare bonus​
• Health Insurance: MEC plan with employer HSA contribution​
• 401K Retirement plan with employer contribution​
• Life Insurance ​
• Short-term disability​
• Dependent Care Flexible Spending Account​
• Time Off: 9 company paid holidays, 5 missions days accrued annually, maternity and paternity leave, FMLA, Bereavement, and weekly accrued PTO (40 hours to use after 30 days 80 hours accrued for 48 weeks)​
• Health club or home workout benefits for participating staff​
• Formal staff development and leadership training​
• Spiritual support and counseling through our staff support office​
• Repeatedly certified as a Best Christian Workplace