Post Payment Support II/Post Payment Administration
Organization Payment Integrity
Emdeon Payment Integrity Solutions help Health Care Payers identify, process and accurately pay only valid healthcare claims efficiently while reducing healthcare dollars lost to fraud, abuse and waste. With its unparalleled repository of claims data, Emdeon has the ability to streamline the information exchange and interpretation, enabling detection of aberrant claims that currently may go unseen, resulting in significant savings for Payers.
Emdeon's innovative solution set offers the most complete healthcare fraud, abuse and waste solution available today. Our product suite empowers payers of all sizes to intelligently automate processes that previously required a significant investment in human resources and IT infrastructure.
Brief Job Description
The Post Payment Administrator is responsible for the coordination of the provider medical record request process to ensure that all requests are being generated and processed in a timely manner. This position is also responsible for following up and obtaining outstanding medical records from providers and ensuring that the provider information is accurate.
• Receive incoming mail and confirm receipt of correct date of service.
• Index and scan medical record copies and related materials.
• Follow up with providers and clients to retrieve medical record receipts for auditing.
• Review of 210 and 211 status reports to identify aging claims and returned problematic medical record requests and resolve issues.
• Compile and verify data for the production of regular and special statistical reports from various sources. Extract information from a variety of medical records and confirm appropriate Post Payment assignments.
• Respond to or clarify internal requests for medical information and conduct searches for information.
• Control inventory of records stored and may have responsibility for all phases of destruction and/or disposition of records.
• Demonstrate commitment to Emdeon values.
• The position responsibilities outlined above are in no way to be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
• Minimum high school diploma or equivalent (i.e. GED)
• Minimum 1 year experience in office or clerical position
• Ability to use software, hardware, and peripherals related to job responsibilities, including MS Office
• Ability to multi task
• Experience with Right Fax and Alchemy
• Communication, organization, analytical, and problem solving skills
• Detail oriented
• Knowledge of auditing preferred; ability to understand auditing required
Chamberlin Edmonds - 14 months ago
Chamberlin Edmonds, an Emdeon company, is a leading provider of comprehensive eligibility and enrollment services with over 26 years of...