Claims Team Lead

SUMMARY: The Claims Team Lead is responsible for the reconciliation of the provider’s reimbursement request forms. In addition, he/she will be responsible for maintaining all departmental filing and other duties that may be assigned.

ESSENTIAL FUNCTIONS

• Correlate the reimbursement request forms and resubmissions by provider per day in chronological order.
• Approvals and denial for reimbursement and resubmissions.
• Data entry.
• Responsible for generating and distributing copies of denied reimbursement requests to providers.
• Filing all reimbursement forms.
• Assisting with special rates from the call center.
• Relays instructions, messages and other information as requested from the management team.
• Maintains a current working knowledge of all company policies, procedures, rules, regulations and memorandums.
• Responsible and accountable for updating management on changes and/or extraordinary circumstances affecting the company and/or transportation provider.
• Other duties as assigned by management team.

REQUIRED SKILLS AND ABILITIES

• Excellent communications skills oral and written.
• Able to work in a busy environment.
• Able to function effectively in stressful situations.
• Knowledge of reconciliation and customer service policies and procedures.
• Knowledge of Medicaid Non-Emergency Transports preferred.
• Able to handle multiple tasks simultaneously.
• Computer experience.
• Following training, able to adequately implement concepts of Route Logic.
• Able to lift and/or move items up to 25 pounds.
• Must be able to key 8000+ keystrokes.

QUALIFICATION

• High School diploma.