BusinessOperations - Scanning Operator - 570043

Claims Processing Specialist

Position

Purpose:

Responsible for scanning and tracking all mailed claims, review requests, medical records and member/provider correspondences. Education/

Experience:

High school diploma or equivalent. 1+ years of administrative or office experience.
• Ensure claims are received and sorted correctly for scanning, and batch and track all offline, deleted, and pulled claims
• Understand and follow procedures and continuously monitor counts in the system queues to ensure the system is working effectively
• Update the claims control sheet in an accurate and timely manner and report unresolved discrepancies immediately to the supervisor
• Process outgoing mail and archive various documents, records and requests
• May be required to lift up to 50 lbs. on a regular basis EEO: "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."

Story Behind the Need

Purpose:

Mail sorting, document identification & determination, document scanning, document forwarding. Need:
Business restructuring. Team:
Each team member is a specialist in individual tasks. All team members are cross trained to backfill specialist positions. Team culture is friendly, driven toward quality assurance & service level agreements. Hiring needs:
This is not part of a larger hiring initiative

Typical Day in the Role

Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique? - Mail arrives to the office by courier between 9:30 – 10:30 am. Staff spend approximately 1 to 1.5 hours pre-sorting envelopes by sight determination & tallying intake counts for reporting. Mail is distributed to team members to be opened, sorted by document determination, similar document types are batched together & scanned.

Once scanning is complete, batches are filed by the end of each business day. Performance expectations: 80 Envelopes open per hour. 40 scans output per hour. 15 claim form batches scanned per hour. Unique role:
Independent work within a team environment. The team works on-site in a secure location only accessible by security badge swipe due to HIPAA compliance regulations. Pace of work fluctuates throughout the week with busiest days being Monday, Thursday & Friday

Candidate Requirements

Required:

High school Diploma/GED

Years of experience required: 1⁄2 preferred but not required Disqualifiers: lack of minimal computer sufficiency Additional qualities to look for: mailroom experience, medical claims experience, medical appeals or medical records experience

Top 3 must-have hard skills stack-ranked by importance - 1 - Microsoft Windows o/s familiarity 2 - Attention to detail 3 - Ability to ask questions & learn from on-the-job training.

Candidate Review & Selection

Shortlisting process Candidate review & selection Interview information Onboard process and expectations - Projected Manager Candidate Review Date:

- 1-2 days post shortlisting Type of Interviews:

- Teams, phone, etc. Required Testing or Assessment (by Vendor):

- Typing test, basic computers skills test, etc.