Dental Unit Claims Processing Team member
Duties include:
• Opening and distributing mail to dental unit staff
• Logging incoming prior authorization requests
• Adding or updating prior authorization records in the MMIS system
• Answering incoming phone calls from providers and recipients;
o Providing basic policy information to callers
o Looking up information in the MMIS system
o When necessary, transferring calls to other dental unit staff.
Previous experience required:
• Data entry
• Basic Microsoft Office toolkit knowledge
•
Nice to have
• Dental or medical claims processing experience
• Answering phones in a medical/dental office environment
DE2
Years of Relevant Experience: 2 to 4 years
Preferred Education: Associates Degree or equivalent
Role Description:
•Comprehensive PC skills.
•Able to follow written and spoken instructions.
•Minimum of 35 wpm.
•Ability to accurately enter information into a computer, accessing information from a computer, and verifying information on a screen.
•Duties involve utilizing automated equipment, including electronic keyboard, display screen, and sorted memory to perform.
•Ability to operate and understand basic scanning and imaging equipment, including pan, skew, and image correction techniques.
•Ability to conduct basic data mining and data capture efforts.
Services may be required to be provided at supplier’s site using supplier’s equipment. Typically need an end product of electronic data, typically transmitted through FTP.
•Keypunch and verify records in specified format (ex. ASCII).
•The total number of keystrokes is limited to actual characters, numbers and special characters that are keyed. Spaces, function keys, nulls, and zeros are not counted as keystrokes.
•The contractor must complete all data forms within an agreed-upon amount of time from receipt or average a minimum of a set number of strokes each week data forms are in possession.
•Error rate cannot exceed 1/2%. Error rate is calculated on a character (not field or record) basis.
•Pickup and delivery by contractor to be made on a weekly basis.
•For key entry, required that a second individual completed NA% key verification to control errors.
•Knowledge of imaging and visual display operating practices, procedures, and techniques.
•Knowledge of arithmetic and numbering systems.
•Ability to operate equipment with speed and accuracy to ensure information is captured.
Skill | Required /Desired | Amount | of Experience |
---|---|---|---|
Data Entry | Required | 2 | Years |
MS Office | Required | 2 | Years |
Help Desk / Reception | Required | 2 | Years |
Dental or Medical Claims Processing | Nice to have | 0 | |
Customer Service in Dental or Medical Office | Nice to have | 0 |
Associates Degree