Job Description
Job Title: Projects Representative
Division: MedSrv CBO (Central Business Office)
Reports to: Operations Manager
FLSA Status: Non-Exempt
Revised Date: 8/16/22
SUMMARY
Support all departments in the CBO assist with special projects, analyzing denial reports, trend denial behavior, request charge review rules, claim edit rules, work targeted WQ’s, research payer requirements associated with denials, review existing workflows for improvement, etc. Will complete high level training in all departments to ensure there is a basic understanding of major processes and workflows. Work closely with Revenue Cycle Director, Operations Director, and AR Mangers.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Complete basic training for all departments
- Understand major workflows for all departments
- Use reporting tools in EPIC to identify denial trends
- Identify and request necessary charge review edits
- Analyze existing workflows to see if there is room for improvement
- Assist all departments with special projects upon request
QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE
High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience. Must be fluent in all Microsoft Office applications, excel, word, teams, share point etc.
LANGUAGE SKILLS
Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
MATHEMATICAL SKILLS
Ability to add, subtract, multiply, and divide in all units of measure, using who numbers, common fractions, and decimals.
REASONING ABILITY
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations. Ability to learn and comprehend basic insurance terminology and protocols to handle patient accounts.
PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to sit, use hands to finger, handle, or feel; reach with hands and arms; and talk or hear. Specific vision abilities required by this job include ability to adjust focus.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.