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Insurance Claims Compliance Specialist


WalkerHeathcareIT
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Post Date: Aug 07, 2014
Job Type: Contract to hire
Start Date: - n/a -
Compensation: - n/a -
Location: US - Wisconsin - Waukesha
Reference: 818
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Description
WalkerHealthCareIT is seeking a Quality Assurance Specialist with insurance industry experience for a Temp-to-Perm position in Waukesha, WI.

DESCRIPTION:

Responsible for evaluating the quality of services and interactions provided by departments within the organization.

Auditing processes related to enrollment and billing and claims processing.

Handling customer service written and verbal inquiries.

Evaluating the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.

Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.

Tracks and trends audit results, providing feedback to management.

Identifies and reports on systemic issues which create ongoing quality concerns.

Generates monthly reports of audit findings, supports clients with issues identified and develops reports to assist management with information requested.

Produces other ad hoc reports as requested by internal and/or external clients.

REQUIREMENTS:

Requires high school diploma or equivalent (GED)
2 years’ experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector

Working knowledge of insurance industry and medical terminology

Working knowledge of relevant systems and proven understanding of processing principles, techniques and guidelines

Ability to acquire and perform progressively more complex skills and tasks in a production environment or any combination of education and experience, which would provide an equivalent background.


WalkerHealthcareIT:

WalkerHealthcareIT recruits IT and Healthcare Technology professionals to assist Healthcare organizations with the movement to an integrated health system. We provide experienced contract consultants to help our clients navigate the huge changes that are coming as medicine shifts towards accountable care, electronic health records, and the use of and clinical informatics. We also provide EMR Technology contractors to assist clients with the implementation and administration of their EHR/EMR systems. We provide Contract, Contract-to-Hire and Permanent Placement recruitment services across all Healthcare IT application categories, from core clinical and patient data platforms to complex billing environments including; Ambulatory and Inpatient Systems, Clinical and Revenue Cycle Implementation, Electronic Medical Records (EMR) and Financial and Billing Systems.





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