The Senior Data Coordinator is responsible for routine clerical functions to support daily operations within the Claims Department, thus contributing to a smooth workflow, and efficient processing of claims. This position will include responsibility of data entry of information included in standard medical claim forms (HCFA, UB04), invoices, and escalated claims into various databases. In addition, this position will handle all incoming and outgoing mail function to include distribution, documentation, counting, sorting and batching to our external vendors. This position will support the Claims department by consistently meeting quality and production goals in the processing of information. Primary Responsibilities:Accurately inputs claim batches and keys all pertinent information from claims documentation, (including all fields from HCFA and UB04 forms) and office fee tickets (including ICD9 codes, ICD 10 and CPT coding)Verifies all data elements are available including member eligibility on claims prior to data entryAnalyzes claim rejections from clearing house, various error claim reports such as member reject reports etc. for data entry and or return to providers lettersProcesses all incoming daily mail/correspondence to include, opening envelopes, date stamping of member mail with current receipt dates, verification of eligibility, opening of all mail, sorting out mail by market specific and/or provider specificRoutes claims for back end scanning to vendors, maintains departmental files, reports, and retrieval of documentation with vendors. Prepares documentation for older claim files for archiving with vendors and maintains log for future retrievalResponsible for all faxes for routing to various departments and or scanning with our vendorMeets and maintains quality and production goals related, but not limited to, phone calls, overpayments, unsolicited checks, appeals, TDI complaints and processingCoordinates with the Claims Manager and/or Claims Supervisor on workflow issues and the handling of first in first out order to ensure turnaround times are metPerforms all other related duties as assigned
Required Qualifications: High School Diploma or GEDTwo to three years of administrative support experience, or working with database management, data entry or data managementKnowledge of Microsoft Office applications including Word, Excel, PowerPoint and AccessKnowledgeable of ICD-9, ICD-10 and CPT codingBasic phone, filing and typing skillsAbility to lift up to 25 poundsAbility to sit for extended periods of timeAbility to stand for extended periods of timeAbility to use fine motor skills to operate office equipment and/or machineryAbility to receive and comprehend instructions verbally and/or in writingAbility to use logical reasoning for simple and complex problem solving Preferred Qualifications: 6 - 12 or more months of claims processes and or healthcare experience6 - 12 months related experience in the healthcare industry Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Claims, data entry, eligibility, San Antonio, TX, Texas
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.