Representative, CBO Registration Team (Remote)

Job Title:Registration Team

Division: MedSrv CBO (Central Business Office)

Reports to: Operations Manager

FLSA Status: Non-Exempt

SUMMARY

Work all back-office registration issues. Registration issues are identified during claim edit scrubbing, electronic payer rejections and/or payer denials. Will utilize real time eligibility software in EPIC to troubleshoot. When resources are not provided for resolution, the guarantor will be contacted via statement/letter for assistance. Applicant needs to have a strong grasp on how insurance eligibility works and how eligibility responses are connected to payers and payer plans in EPIC.

ESSENTIAL DUTIES AND RESPONSIBILITIES

· Review and resolve claim edits associated with registration errors

· Review and resolve 277 rejections from the payer associated with registration errors

· Review and resolve denials from the payer associated with registration errors

· Utilize Real Time Eligibility in EPIC to troubleshoot registration issues

· Review RTE responses in EPIC to determine if there is a payer mapping issue or end user error

· Understanding how payers, alternate payers and payer plans work in EPIC

· Load payers, remove payers, change payer order, etc. when necessary

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.