POSITION SUMMARY
The Repricing Specialist I is responsible for re-pricing medical (CMS1500, UB04) and dental claims through the use of multiple applications to obtain discounted rates.
ESSENTIAL FUNCTIONS
- Repricing of CMS1500 and UB04 forms for various PPO networks
- Ability to use several different computer applications to obtain the information needed to correctly re-price a claim
- Ability to key claims once repriced into the QicLink system
- Ability to communicate effectively with various departments to resolve issues
- Must be able to re-price and key claims with a minimum of 99% accuracy
- Trainer of existing workflow updates/changes to team
- Handling of escalated issues/call notes/appeals/emails
- Assistance with escalated DocuVantage Issues (EDI)
- Assistance with Product Implementation – Client specific requests/workflows/contracts/projects
- Other duties as assigned
EDUCATION
- High School Education or equivalent required.
EXPERIENCE AND SKILLS
- 2-3 years experience in data entry required
- Experience with HCFA and UB92’s strongly preferred
- Microsoft Word, Excel, Outlook, Access databases software programs
- Ability to key a minimum of 10,000 keystrokes per hour.
POSITION COMPETENCIES
- Accountability
- Communication
- Customer Service Orientation
- Functional/Technical Skills
- Quality Focus
- Time and Task Management
PHYSICAL DEMANDS
- This is a standard desk role that requires extended periods of sitting and computer work
WORK ENVIRONMENT
- Remote
Here at Allied, we believe that great talent can thrive from anywhere. Our remote friendly culture offers flexibility and the comfort of working from home, while also ensuring you are set up for success. To support a smooth and efficient remote work experience, the internet connection must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 100Mbps download/25Mbps upload. Reliable internet service is essential for staying connected and productive.
The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.
Compensation is not limited to base salary. Allied values our Total Rewards, and offers a competitive Benefit Package including, but not limited to, Medical, Dental, Vision, Life and Disability Insurance, Generous Paid Time Off, Tuition Reimbursement, EAP, and a Technology Stipend.
Allied reserves the right to amend, change, alter, and revise, pay ranges and benefits offerings at any time. All applicants acknowledge that by applying to the position you understand that the specific pay range is contingent upon meeting the qualification and requirements of the role, and for the successful completion of the interview selection and process. It is at the Company's discretion to determine what pay is provided to a candidate within the range associated with the role.
Skills Required
- High school education or equivalent
- 2–3 years of data entry experience
- Ability to use multiple computer applications for claim repricing
- Ability to key claims with a minimum of 99% accuracy
- Minimum typing speed of 10,000 keystrokes per hour
- Experience with HCFA and UB92 claim forms
- Proficiency with Microsoft Word, Excel, Outlook, and Access
- Cable broadband or fiber internet with at least 100 Mbps download and 25 Mbps upload
What We Do
Allied is a national healthcare solutions company that works with organizations who choose to take control of their healthcare. We customize employer self-insurance benefits to align with individual choice and organizational need while integrating medical management innovations and cost-control strategies. With healthcare designed for people, employers never have to choose between price and the best-fit insurance products to protect employees and their families. Allied’s philosophy is to create a culture of health for our member organizations and their employees beyond simple, medical health. We integrate administrative services, care solutions and analytics to achieve better clinical, behavioral and social patient outcomes. Allied’s programs and benefit services are designed and structured to infuse value on every front – for employers and HR departments, for plan members and their families, for healthcare providers, and for us. We’re in this together, committed to your future.
