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AIS - Processor II DPS Exception Workflow
Concentra
Addison, Texas, United States

Job Summary

Occupation Physician
Specialty Other
Degree Required MD/DO
Position Type Permanent/Full-Time
Work Environment Ambulatory Surgery Center (ASC) Academic/Training Program Hospital Clinic/Private Practice
Location Daphne, Alabama, United States
Visa Sponsorship No
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Job Description

Last Update: 11/13/14

JOB SUMMARY:

The indexing or medical bill review (MBR) processor will be expected to use WebRePrice, Adjuster Desktop, Medflow, AISs proprietary software, to sort medical documentation information, research claims or key in medical bill information following established guidelines, while insuring accuracy and meeting daily quotas

MAJOR DUTIES AND RESPONSIBILITIES:

  • Processmedical claims according to fee schedule rules and regulations
  • Familiarwith medical terminology, including knowledge of CPT, ICD9, and PIPstatues.
  • Know and understand policies and procedures as they pertain to each document
  • Able to work continual adjusting required hours / days
  • Ability to perform arithmetic calculations
  • Ability to identify and choose noted claim / adjuster numbers
  • Ability to adjust/alter workflow to meet deadlines
  • Ability to operate a ten-key calculator with a data entry score of 9,000 or > with 98% accuracy
  • Ability to identify provider information and other documentation received in the course of performing duties
  • Reviews and corrects errors on records rejected by computerized system.
  • Ability to handle confidential information
  • Keys data for records rejected by system processing.
  • Submits processed materials for next-step processing.
  • Monitors progress and adjusts process or schedule to expedite timely completion.
  • Maintains productivity and quality standards as determined by the business needs on a continuous basis.
  • Verify bill accuracy on high dollar bills processed
  • Self-motivated, goal-orientated with the ability to work under a fast paced and demanding, yet rewarding, work environment.
  • Ability to identify and organize between billings, doctors notes, attorney letters and other documentation received in the course of performing duties
  • Self-motivated, goal-orientated with the ability to work under a fast paced and demanding, yet rewarding, work environment
  • Other duties as assigned.

WORKING CONDITIONS/PHYSICAL DEMANDS:

Office environment

Concentra's Data Protection Commitment
* Concentra is committed to protect patient data and to ensure privacy of personal and medical information.
* Every Concentra colleague has the responsibility to adhere to data protection principles.
* If a colleague's role includes handling or processing sensitive data, role-specific policies and requirements apply to ensure the protection of patient information.