Claims Processor; DOH​/PHD

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Job Requirements & Classification

Description:

INTERVIEWS ARE ANTICIPATED TO BE CONDUCTED WITHIN TWO WEEKS OF CLOSING DATE.

The New Mexico Department of Health (NMDOH) is one of the executive branch agencies of the State of New Mexico. Our mission is to ensure health equity, we work with our partners to promote health and well-being and improve health outcomes
for all people in New Mexico.

(Describe the program...)
Breast and Cervical Cancer Early Detection Program ...a Public Health Program within the Population and Community Health Bureau (PCHB) of the New Mexico Department of Health.

This position provides clerical, reimbursement, and administrative tasks for the Breast & Cervical Cancer Early Detection Program and the Population and Community Health Bureau.

The program provides free breast and cervical cancer screenings to low income, uninsured New Mexicans.

This position provides clerical and reimbursement tasks for the Breast & Cervical Cancer Early Detection Program and the Population and Community Health Bureau. The program provides free breast and cervical cancer screenings to low income New Mexicans. This position performs data entry of medical and payment information that is entered daily into three inter-connected computerized systems to ensure reimbursement in a timely manner.

Data entry of each client
¿ s medical information is entered into a secure database that is used to generate required data submissions to the program
¿ s federal funding agency (CDC) twice each year. The position provides ongoing support to contracted healthcare providers and facilities, as well as to internal staff. This position must maintain HIPAA compliance. Additional duties performed by the person in this position include: filing claims and generating payment lists; verifying explanation of payments (EOPs) and sending EOPs to assigned providers; opening, date stamping, sorting, logging, and distributing Bureau mail;

answering telephones; operating photocopiers/scanners, postage machines and monitoring incoming electronic faxes; and archiving of claims at the close of every fiscal year.

The program works to reduce the burden of breast and cervical cancer in New Mexico. This position supports the program's statewide network of contracted healthcare providers and the low income and uninsured individuals receiving breast and cervical cancer screening services funded by the program.

• - Competent performing data entry, prioritizing, and multi-tasking
• - Experienced processing medical billing
• - Focused on high-quality customer service and clear communication
• - Independent Worker
• - Proficient with word processing, computer software applications, and operating photocopier/scanner and postage machine
• - Bilingual (proficient in both English and Spanish)

No prior experience or training required.

Must possess and maintain a valid Driver's License.

Must possess and maintain a current Defensive Driving Course Certification from the State of New Mexico or must pass and receive Defensive Driving Course Certification as a condition of continued employment.

Work in an office cubicle setting with exposure to visual/video display terminal (VTD) and extensive personal computer and phone usage. Ability to lift up to 40 lbs (bending, stooping and reaching) and meet numerous deadlines.

This position is covered by a collective bargaining agreement and all terms/conditions of that agreement apply and must be adhered to.