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Group Claims Representative

  • Location

    Pittsburgh, United States

  • Sector:

    Other Area(s)

  • Job type:

    Contract

  • Contact:

    Leric Arcigal

  • Job ref:

    22609

  • Published:

    11 months ago

  • Expiry date:

    2021-01-01

Overview

This is an entry level position responsible for processing all release of information specifically medical record requests in a timely and efficient manner ensuring accuracy and providing customers with the highest quality product and customer service. Associate must at all times safeguard and protect the patients right to privacy by ensuring that only authorized individuals have access to the patients medical information and that all releases of information are in compliance with the request, authorization, company policy and HIPAA regulations. Responsibilities

Supports the Disability product lines by partnering with internal and external customers throughout the medical records request process.

Initiates outgoing requests by fax, mail, e-mail or via portal, for information in a timely manner. Maintains confidentiality, information security and ethical behavior when requesting all medical records information

Ensures that all requests have the appropriate authorizations for release of medical information according to established procedures and HIPAA guidelines.

Completes timely follow ups and accurately documents any actions taken within the appropriate areas in the system.

Demonstrates helpful and effective telephone etiquette and customer service skills by providing appropriate information to callers.

Responds timely, professionally and courteously to all internal and external customer inquiries.

Monitors various medical records portals daily and shares any records received with the appropriate Claim Managers and uploads the records into Workbench, if appropriate.

Works within scope of position and direction; willingly accepts assignments and is available to take on additional work, as needed, and assist with peer backlogs.

Ability to adapt to change and respond to difficult and challenging situations in a professional manner.

Communicates with Manager on an on-going basis, providing information and data as requested including businesss changing needs and requests.

Promptly reports to Manager any customer service concerns and/or any potential HIPAA violations whether actual or perceived.

Informs Manager of site or work difficulties, and fluctuating volume in daily workload.

Ability to accurately and efficiently utilize a computer for data input, retrieval of data and all other tasks associated with release of information services and time reporting.

Ability to work with minimum supervision, organize workload and prioritize work tasks to meet production and quality goals.

Adheres to the Companys Code of Conduct and business standards.