We’ve learned that what is best for patients is also best for employees. Learn more about why we are one of the Best Companies to Work for in Texas.
JOB SUMMARY:
Must have the ability to communicate both verbally and in writing. Mainframe computer skills, basic accounting, detailed clerical skills and good customer relation skills are required. Candidate must manage accounts according to third party payer rules and regulations. Candidate must posses an understanding of medical and third party payer terminology.
REPORTS TO:
JOB SPECIFIC RESPONSIBILITIES:
•Process claim production queues appropriately
• Review claim production reports and claim production edit reports
• Understand payer specific requirements for electronic and paper claim submission
• Document accurately on visits in IDX to convey the billing issue for correction.
• Take corrective action when errors are noted on claims
• Review payer confirmation reports to ensure all transmitted claims were received by payers
• Review paper claims to ensure that affected claims cannot be submitted electronically
• Work hold bills assigned by supervisor
• Communicates effectively with supervisor and staff to reduce the number of recurring claim
errors
• Audits the payer table within Click-On to ensure that claims are submitted to the correct payers
EDUCATION AND EXPERIENCE:
High school graduate or equivalent required.
REQUIRED LICENSURES/CERTIFICATIONS/REGISTRATIONS:
None required.
SKILLS AND ABILITIES:
Highly technical. Troubleshooting skills are required.
INTERACTION WITH OTHER DEPARTMENTS AND OTHER RELATIONSHIPS:
This position requires interaction with most other UMC Health System departments, medical staff, and technical personnel at Texas Tech University Health Sciences Center and Physician Network Services. This position also deals directly with technical support analysts employed by contracted hardware and software vendors.
PHYSICAL CAPABILITIES:
Work is of medium demand. Walking, sitting and standing most of the time while on-duty. Occasional lifting of equipment is required. Adequate hand/eye coordination and fine motor skills required for typing. Talking and hearing is essential in dealing with co-workers and customers.
ENVIRONMENTAL/WORKING CONDITIONS:
Works in a well-lighted, heated and ventilated building.
DIRECT REPORTS:
UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
*Request for accommodations in the hire process should be directed to UMC Human Resources.*
Claims Management Specialist • Albuquerque
Worker Compensation Claims Examiner III (Hybrid).Hybrid Albuquerque Office - Albuquerque, NM 87110.Under minimal supervision, manages all aspects of indemnity claims handling from inception to con... Show more
Account Specialist Job Duties: Prepares work to be processed by gathering, sorting, organizing, and recording data, information, and documents.Co... Show more
RRI) is one of the largest independently owned providers of Loss Control to the property and casualty Insurance industry.We specialize in Property, General Liability, Products Liability, Fleet, Inl... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
Field Claims Representative - New Mexico (Albuquerque or Santa Fe)Acuity is seeking a Field Claims Representative to investigate, record facts, preserve evidence, determine coverage.The representat... Show more
DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day.As a Dasher, you’ll stay busy with a var... Show more
Compile statistical data and other information for further analysis Estimate the probability and likely economic cost of an event such as death, sickness, an accident, or a natural disaster Design,... Show more
This position assists with planning, implementation, evaluation, and documentation of a proactive continuous survey readiness program for the organization designed to reduce and eliminate the risk ... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
Position Type: Full Time Job Shift: Full Time Education Level: Bachelor's Degree or Experience Travel Percentage: Minimal Travel Category: Banking.Location: Albuquerque, NM 87109.Required work sche... Show more
Earn up to $400/week, depending on the number and type of studies you complete.Share honest feedback on products and services from independent brands.Assignments include short online surveys (10–20... Show more
Remote Jobs are now available in your area.This position is a work from home position.You will not need to come into the office.Benefits: Health Insurance, 401K, Vacation& PTO.Apply now! Work f... Show more
Duties and responsibilities vary and may increase according to grade level****.Review requisition package for adequacy, consistency, and compliance with administrative, regulatory, and procedural r... Show more
Materials Management, Clinical Resource Specialist.Join our team as a day shift, full-time, Materials Management, Clinical Resource Specialist in Albuquerque, NM.Thrive in a People-First Environmen... Show more
Claims Team Lead, Transportation (APD)Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims.Founded by insurtech vete... Show more
We’re looking for experienced, reliable, and safety-focused OTR Truck Drivers to haul dry van freight across all 48 states.Whether you’re a seasoned road warrior or looking for a fresh start with a... Show more
Start your career with Enterprise Mobility! We're hiring immediately for our respected Management Training Program.Whether you see yourself in sales, business development, customer service, retail ... Show more
Our client has an immediate need for a Contracts Specialist to join their team in Albuquerque, NM.MUST HAVE A TS/SCI TO BE CONSIDERED FOR POSITION.Manage contract process on assigned contracts from... Show more
ERM is hiring a Construction Safety Specialist to support day-to-day construction field verification activities in Santa Teresa, NM.The Specialist will spend most of their time in the field observi... Show more
Product Testers are wanted to work from home nationwide in the US to fulfill upcoming contracts with national and international companies.We guarantee 15-25 hours per week with an hourly pay of bet... Show more
